a Department of Occupational and Environmental Medicine , Lund University , Lund , Sweden.
b Research and Development Unit, City Office , City of Malmö , Malmö , Sweden.
Aging Ment Health. 2018 Oct;22(10):1344-1350. doi: 10.1080/13607863.2017.1348483. Epub 2017 Aug 21.
To investigate the possible association between severity of intellectual disability (ID) and presence of challenging behavior, respectively, on diagnoses of psychiatric disorders among older people with ID.
People with a diagnosis of ID in inpatient or specialist outpatient care in 2002-2012 were identified (n = 2147; 611 with mild ID, 285 with moderate ID, 255 with severe or profound ID, and 996 with other/unspecified ID). Moreover, using impairment of behavior as a proxy for challenging behavior, 627 people with, and 1514 without such behavior were identified.
Severe/profound ID was associated with lower odds of diagnoses of psychotic, affective, and anxiety disorders than was mild/moderate ID. People with moderate ID had higher odds than those with mild ID of having diagnoses of affective disorders. Diagnoses of psychotic, affective, and anxiety disorders, and dementia were more common among people with challenging behavior than among those without.
People with severe/profound ID had lower odds of receiving psychiatric diagnoses than those with mild and moderate ID. Whether this is a result of differences in prevalence of disorders or diagnostic difficulties is unknown. Further, challenging behaviors were associated with diagnoses of psychiatric disorders. However, the nature of this association remains unclear.
调查智力障碍（ID）严重程度与挑战性行为之间可能存在的关联，以及这些因素与老年人精神障碍诊断之间的关系。
2002 年至 2012 年期间，在住院或专科门诊治疗中被诊断为 ID 的人群（n=2147；611 例轻度 ID，285 例中度 ID，255 例重度或极重度 ID，996 例其他/未特指 ID）被确定。此外，使用行为障碍作为挑战性行为的替代指标，确定了 627 名有行为障碍的人和 1514 名无行为障碍的人。
与轻度/中度 ID 相比，重度/极重度 ID 与精神病性、情感和焦虑障碍的诊断几率较低。与轻度 ID 相比，中度 ID 人群患情感障碍的几率更高。与无挑战性行为的人相比，有挑战性行为的人更常见被诊断为精神病性、情感和焦虑障碍及痴呆症。
与轻度和中度 ID 相比，重度/极重度 ID 人群获得精神障碍诊断的几率较低。这是由于疾病流行率的差异还是诊断困难尚不清楚。此外，挑战性行为与精神障碍的诊断有关。然而，这种关联的性质仍不清楚。
