Antipsychotic and antidepressant prescribing for 704 297 children and young people with and without intellectual disabilities: record linkage study

Henderson, A. , Kinnear, D. , Fleming, M. , Stanley, B. , Greenlaw, N. , Young-Southward, G., Pell, J. P. and Cooper, S.-A. (2021) Antipsychotic and antidepressant prescribing for 704 297 children and young people with and without intellectual disabilities: record linkage study. British Journal of Psychiatry, 218(1), pp. 58-62. (doi: 10.1192/bjp.2020.232) (PMID:33541472)

Abstract

Background Psychotropics are overprescribed for adults with intellectual disabilities; there are few studies in children and young people. Aims To investigate antipsychotic and antidepressant prescribing in children and young people with and without intellectual disabilities, and prescribing trends. Method Scotland's annual Pupil Census, which identifies pupils with and without intellectual disabilities, was record-linked to the Prescribing Information System. Antidepressant and antipsychotic data were extracted. Logistic regression was used to analyse prescribing between 2010 and 2013. Results Of the 704 297 pupils, 16 142 (2.29%) had a record of intellectual disabilities. Antipsychotic and antidepressant use increased over time, and was higher in older pupils; antipsychotic use was higher in boys, and antidepressant use was higher in girls. Overall, antipsychotics were prescribed to 281 (1.74%) pupils with intellectual disabilities and 802 (0.12%) without (adjusted odds ratio 16.85, 95% CI 15.29–18.56). The higher use among those with intellectual disabilities fell each year (adjusted odds ratio 20.19 in 2010 v. 14.24 in 2013). Overall, 191 (1.18%) pupils with intellectual disabilities and 4561 (0.66%) without were prescribed antidepressants (adjusted odds ratio 2.28, 95% CI 2.03–2.56). The difference decreased each year (adjusted odds ratio 3.10 in 2010 v. 2.02 in 2013). Conclusions Significantly more pupils with intellectual disabilities are prescribed antipsychotics and antidepressants than are other pupils. Prescribing overall increased over time, but less so for pupils with intellectual disabilities; either they are not receiving the same treatment advances as other pupils, or possible overprescribing in the past is changing. More longitudinal data are required.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stanley, Miss Bethany and Young-Southward, Ms Genevieve and Cairns, Professor Deborah and Henderson, Mrs Angela and Cooper, Professor Sally-Ann and Pell, Professor Jill and Greenlaw, Miss Nicola and Fleming, Dr Michael
• Authors: Henderson, A., Kinnear, D., Fleming, M., Stanley, B., Greenlaw, N., Young-Southward, G., Pell, J. P., and Cooper, S.-A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: British Journal of Psychiatry
• Publisher: Cambridge University Press
• ISSN: 0007-1250
• ISSN (Online): 1472-1465
• Published Online: 28 December 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in British Journal of Psychiatry 218(1): 58-62
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
302957		Mental Health Data Pathfinder	Daniel Smith	Medical Research Council (MRC)	MC_PC_17217	HW - Mental Health and Wellbeing