Pharmacotherapy for mood and anxiety disorders in older people with intellectual disability in comparison with the general population

People with intellectual disability (ID) have high prevalence of psychiatric disorders, but even higher rates of prescription of psychotropic drugs. Using Swedish national registers, we identified a group of older people with ID and diagnosis of mood disorders (ICD-10 codes F32-F39) and/or anxiety (...

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Bibliographic Details
Published in:	BMC psychiatry 2019-08, Vol.19 (1), p.238-238, Article 238
Main Authors:	Axmon, Anna, El Mrayyan, Nadia, Eberhard, Jonas, Ahlström, Gerd
Format:	Article
Language:	eng
Subjects:	Adult Aged Aged, 80 and over Aging Agonists Analysis Anesthesia Antianxiety agents Antidepressants Anxieties Anxiety Anxiety disorders Anxiety Disorders - drug therapy Anxiety Disorders - psychology Anxiolytics Autism Care and treatment Clinical Medicine Cohort Studies Diagnosis Down syndrome Drug prescription Drug therapy Emotional disorders Female GABA Generalized linear models Humans Hypnotics Intellectual disabilities Intellectual Disability - psychology Klinisk medicin Male Medical and Health Sciences Medical research Medicin och hälsovetenskap Mental disorders Mental retardation Middle Aged Mood Mood disorders Mood Disorders - drug therapy Mood Disorders - psychology Older people Practice Patterns, Physicians' - statistics & numerical data Prescription drugs Prevalence studies (Epidemiology) Psychiatry Psychological aspects Psychotropic drugs Psychotropic Drugs - therapeutic use Psykiatri Risk factors Sedatives Sweden Tranquilizing agents Tricyclic antidepressants γ-Aminobutyric acid
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Summary:	People with intellectual disability (ID) have high prevalence of psychiatric disorders, but even higher rates of prescription of psychotropic drugs. Using Swedish national registers, we identified a group of older people with ID and diagnosis of mood disorders (ICD-10 codes F32-F39) and/or anxiety (ICD-10 code F4) during 2006-2012 (n = 587) and a referent group of people from the general population with the same diagnoses during the same time period (n = 434). For both groups, we collected information on prescription of anxiolytics, hypnotics and sedatives, antidepressants, and GABA-agonists. Among those with a diagnosis of anxiety, people with ID were more likely than those in the general population to be prescribed anxiolytics (Relative Risk 1.32 [95% Confidence Interval 1.19-1.46]) and GABA-agonists (1.10 [1.08-1.31]). Moreover, among those with anxiety but without mood disorders, ID was associated with increased prescription of antidepressants (1.20 [1.03-1.39]). Within the ID cohort, behaviour impairment and MSP (i.e. moderate, severe, or profound) ID was associated with increased prescription of anxiolytics, both among those with anxiety (1.15 [1.03-1.30] for behaviour impairment and 1.23 [1.10-1.38] for MSP ID) and among those with mood disorders (1.14 [0.97-1.35] for behaviour impairment and 1.26 [1.04-1.52] for MSP ID). Moreover, MSP ID was associated with increased prescription of GABA-agonists among those with anxiety (1.23 [1.10-1.38]). The excess prescription of anxiolytics but not antidepressants may suggest shortages in the psychiatric health care of older people with intellectual disability and mood and anxiety disorders.
ISSN:	1471-244X 1471-244X