Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study

Objectives To describe the incidence of recorded mental illness and challenging behaviour in people with intellectual disability in UK primary care and to explore the prescription of psychotropic drugs in this group. Design Cohort study. Setting 571 general practices contributing data to The Health...

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Bibliographic Details
Published in:BMJ (Online) 2015-09, Vol.351, p.h4326-h4326
Main Authors: Sheehan, Rory, Hassiotis, Angela, Walters, Kate, Osborn, David, Strydom, André, Horsfall, Laura
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antipsychotics
Autism
Behavior disorders
Bipolar disorder
Codes
Cohort analysis
Cohort Studies
Comorbidity
Dementia
Dementia disorders
Drug development
Drug use
Epilepsy
Estimates
Female
Humans
Intellectual disabilities
Intellectual Disability - drug therapy
Intellectual Disability - epidemiology
Male
Mental disorders
Mental Disorders - drug therapy
Mental Disorders - epidemiology
Middle Aged
Multivariate Analysis
Population
Population studies
Population-based studies
Practice Patterns, Physicians' - trends
Prescription drugs
Prescriptions - statistics & numerical data
Primary care
Psychosis
Psychotropic drugs
Psychotropic Drugs - therapeutic use
Schizophrenia
United Kingdom - epidemiology
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Summary:Objectives To describe the incidence of recorded mental illness and challenging behaviour in people with intellectual disability in UK primary care and to explore the prescription of psychotropic drugs in this group. Design Cohort study. Setting 571 general practices contributing data to The Health Improvement Network clinical database. Participants 33 016 adults (58% male) with intellectual disability who contributed 211 793 person years’ data. Main outcome measures Existing and new records of mental illness, challenging behaviour, and psychotropic drug prescription. Results 21% (7065) of the cohort had a record of mental illness at study entry, 25% (8300) had a record of challenging behaviour, and 49% (16 242) had a record of prescription of psychotropic drugs. During follow-up, the rate of new cases of mental illness in people without a history at cohort entry was 262 (95% confidence interval 254 to 271) per 10 000 person years and the rate of challenging behaviour was 239 (231 to 247) per 10 000 person years. The rate of new psychotropic drug prescription in those without a previous history of psychotropic drug treatment was 518 (503 to 533) per 10 000 person years. Rates of new recording of severe mental illness declined by 5% (95% confidence interval 3% to 7%) per year (P
ISSN:0959-8138
1756-1833
1756-1833
DOI:10.1136/bmj.h4326