Little is known about psychiatric and behavioural factors associated with psychotropic
drug use and how appropriately these drugs are prescribed in settings for people with
intellectual disabilities. The aim of this study was to measure the point prevalence
of psychotropic drug use in a problem-behaviour group (PBG) consisting of intellectually
disabled residents of group homes compared to a random group (RG), and to gain insight
in possible factors that are associated with group membership. From all group homes
in the Netherlands, 573 problematic residents were selected by the staff (one resident
from each home) and 1479 residents were randomly sampled from all of the homes. Mental
health problems were measured using the Reiss Screen for Maladaptive Behaviour and
the Psychopathology Instrument for Mentally Retarded Adults. The response rate in
the PBG was 68.9 % and in the RG 71.7 %. Psychotropics (excluding anticonvulsants)
were used by 52.6 % of the PBG and by 22.8 % of the RG. Young age, psychotic, anxiety,
and aggression symptoms were significantly associated with the PBG, as was the use
of antipsychotics and antidepressants. The PBG more often used multiple (three or
more) drugs (17.3 %) than the RG (7.3 %). A low prevalence of antidepressants or mood
stabilisers, antipsychotics, and anxiolytics was found in residents with affective,
psychotic, or anxiety symptoms. We conclude that psychotropic drug use in the PBG
compared to the RG was high. It is likely that the group-home staff finds it difficult
to deal with young people with socially disruptive behaviour, which is underlined
by our finding of high prevalence of antipsychotics and multiple-drug therapy in the
PBG. Finally, our findings suggest that a considerable number of residents with psychiatric
or behavioural symptoms are undertreated.
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MD Joost J. Stolker
Altrecht, Institute for Mental Health Care
Dolderseweg 164
3734 BN Den Dolder
The Netherlands
Phone: +31 30 2256306
Fax: +31 30 2256967
Email: j.stolker@altrecht.nl
