Rory Sheehan|Angela Hassiotis|Kate Walters|David Osborn|André Strydom|Laura Horsfall
Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study
University College London|University College London|University College London|The Royal Free Hospital|University College London|University College London|University College London|The Royal Free Hospital
describe incidence recorded mental illness challenging behaviour people intellectual disability uk primary care explore prescription psychotropic drugs groupcohort study571 general practices contributing data health improvement network clinical database33016 adults 58 male intellectual disability contributed 211793 person years dataexisting new records mental illness challenging behaviour psychotropic drug prescription21 7065 cohort record mental illness study entry 25 8300 record challenging behaviour 49 16242 record prescription psychotropic drugs followup rate new cases mental illness people without history cohort entry 262 95 confidence interval 254 271 per 10000 person years rate challenging behaviour 239 231 247 per 10000 person years rate new psychotropic drug prescription without previous history psychotropic drug treatment 518 503 533 per 10000 person years rates new recording severe mental illness declined 5 95 confidence interval 3 7 per year p0001 new prescriptions antipsychotics declined 4 3 5 per year p0001 1999 2013 new prescriptions mood stabilisers also decreased significantly rate new antipsychotic prescribing significantly higher people challenging behaviour incidence rate ratio 208 95 confidence interval 190 227 p0001 autism 179 156 204 p0001 dementia 142 112 181 p0003 older age control sociodemographic factors comorbiditythe proportion people intellectual disability treated psychotropic drugs far exceeds proportion recorded mental illness antipsychotics often prescribed people without recorded severe mental illness record challenging behaviour findings suggest changes needed prescribing psychotropics people intellectual disability evidence needed efficacy safety psychotropic drugs group particularly used challenging behaviour