Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-University of Queensland (MRI-UQ), Mater Misericordiae Hospital, Brisbane, QLD, Australia.
Ochsner Clinical School, University of Queensland, Brisbane, QLD, Australia.
Aust N Z J Psychiatry. 2023 May;57(5):661-674. doi: 10.1177/00048674221149864. Epub 2023 Jan 26.
This study presents the proportion of adults with intellectual disability using psychotropic medications including antipsychotics, antidepressants, anxiolytics, hypnotics and sedatives, and psychostimulants.
A search was performed in PubMed, Embase, PsycINFO, Web of Science, and Scopus up to 31 December 2021. Articles were included if they reported the proportion of adults with intellectual disability using psychotropic medications. Frequency of use was estimated using a random effects meta-analysis. Meta-regression analysis was used to assess the association between study-level characteristics and variability in estimates, when heterogeneity was considerable.
Twenty-four articles were included in pooled analysis. The pooled prevalence of psychotropic medications was 41% (95% confidence interval: 35-46%). Pooled prevalences of subclasses were as follows: antipsychotics 31% (27-35%), antidepressants 14% (9-19%), anxiolytics 9% (4-15%), hypnotics/sedatives 5% (2-8%), and psychostimulants 1% (1-2%). Heterogeneity was considerable between studies, except for psychostimulants. There was no significant association between assessed characteristics and variability in prevalence estimates.
Two-fifths of adults with intellectual disability were prescribed psychotropic medications. Antipsychotics and antidepressants were used by one-third and one-seventh of adults, respectively. There was considerable variability between studies, and further investigation is required to determine the source of variability. More studies are needed to better characterise prescribed psychotropic medications, including effectiveness and adverse effects, to ensure appropriate use of these drugs.
本研究报告了使用精神药物（包括抗精神病药、抗抑郁药、抗焦虑药、催眠药和镇静剂以及精神兴奋剂）的成年智障人士的比例。
我们在 PubMed、Embase、PsycINFO、Web of Science 和 Scopus 中进行了检索，检索截至 2021 年 12 月 31 日。如果文章报告了使用精神药物的成年智障人士的比例，则将其纳入研究。使用随机效应荟萃分析估计使用频率。当异质性较大时，使用元回归分析评估研究水平特征与估计值变异性之间的关联。
共有 24 篇文章纳入汇总分析。精神药物的总体患病率为 41%（95%置信区间：35-46%）。亚类的总体患病率如下：抗精神病药 31%（27-35%）、抗抑郁药 14%（9-19%）、抗焦虑药 9%（4-15%）、催眠药/镇静剂 5%（2-8%）和精神兴奋剂 1%（1-2%）。除精神兴奋剂外，各研究之间的异质性较大。评估特征与患病率估计值的变异性之间无显著关联。
五分之二的成年智障人士被开了精神药物。抗精神病药和抗抑郁药分别被三分之一和七分之一的成年人使用。各研究之间存在较大的变异性，需要进一步调查以确定变异性的来源。需要更多的研究来更好地描述开处的精神药物，包括有效性和不良反应，以确保这些药物的合理使用。
