Prescribing psychotropic medication for problem behaviours in adults with intellectual disabilities in a specialist psychiatric unit in Hong Kong

Abstract

Psychotropic medications are often used to treat problem behaviours in people with intellectual disability which not only occur frequently but also tend to persist over time. This study examined the pattern of prescription of such medications to manage problem behaviours for adults with intellectual disabilities in a specialist psychiatric unit in Hong Kong. Individuals aged 18 or above with problem behaviours and receiving psychotropic medication for treatment in hospital, outpatient and community settings were studied. Their demographic and clinical information was collected. The type and dosage of medications were retrieved from the computer database and analysed. Those with psychotic disorder and mood (affective disorder) were excluded. After screening, 236 patients met the inclusion criteria. People with moderate intellectual disability accounted for most of the cohort (46%). Autism spectrum disorder was the commonest psychiatric diagnosis (35%) and aggression the commonest problem behaviour (52%). Antipsychotics, mood stabilisers and antidepressants were prescribed to 96%, 20% and 13% of the subjects respectively. The profile of problem behaviour in the Chinese population with intellectual disability is consistent with the findings reported in the world literature. Antipsychotic drugs are the most commonly prescribed class of psychotropic medication used to treat such behaviours. Although the current evidence is not strong enough to support a clear‐cut recommendation on the use of medications, the dichotomous notion of ‘prescription’ or ‘no prescription’ for problem behaviours may be simplistic.