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)

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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 Kinnear, Dr 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 > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > Institute of Health and 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

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
302957Mental Health Data PathfinderDaniel SmithMedical Research Council (MRC)MC_PC_17217HW - Mental Health and Wellbeing