How to Cite
Serna Álvarez , A. M., García Baamonde, M. E., Guerrero-Molina, M. ., & Moreno Manso, J. M. (2023). Use of Psychotropic Drugs in People with Intellectual Disability in Extremadura, Spain. Acta Colombiana De Psicología, 26(1), 200–213. https://doi.org/10.14718/ACP.2023.26.1.13
License
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

 Authors who publish in this journal agree to the following terms:

 Acta Colombiana de Psicología complies with international intellectual property and copyright laws, and particularly with Article No. 58 of the Political Constitution of Colombia, Law No. 23 of 1982, and the Agreement No. 172 of September 30, 2010 (Universidad Católica de Colombia Intellectual Property Regulation).

 Authors retain their copyright and grant to the Acta Colombiana de Psicología the right of first publication, with the work registered under Creative Commons attribution license, which allows third parties to use the published material, provided they credit the authorship of the work and the first publication in this Journal.

Abstract

The use of psychotropic drugs in adults with an intellectual disability is frequent, often for defiant conduct due to the lack of a diagnosis of a mental disorder. Previous research has questioned the efficacy of such treatments in the absence of a psychiatric illness, and the stress has been on the side effects. The objective of this research is to analyze the use of psychotropic drugs based on the diagnosis of mental illness and behavioral disorders, as well as the distribution of the sample according to the use of psychotropic drugs in 569 adults with an intellectual disability who also suffer a mental illness and/or defiant conduct.
Our data about the high prescription of psychotropic drugs and especially antipsychotics, warns of the need for a profound review of the clinical practice that would allow a reduction in the use of psychotropic drugs in the treatment of mental disorders and behaviour in the said collective, so as to guarantee quality mental health care for these persons and respect
for their rights.

Keywords:

References

Ahmed, Z., Fraser, W., Kerr, M. P., Kiernan, C., Emerson, E., Robertson, J., Felce, D., Allen, D., & Thomas, J. (2000). Reducing antipsychotic medication in people with a learning disability. British Journal of Psychiatry, 176(1), 42- 46. http://dx.doi.org/10.1192/bjp.176.1.42

Alexander, R. T., Shankar, R., Cooper, S. A., Bhaumik, S., Hastings, R., Kapugama, C., Tromans, S. J., & Roy, A. (2017). Challenges and pitfalls of antipsychotic prescribing in people with learning disability. British Journal of General Practice, 67(661), 372-373. http://dx.doi. org/10.3399/bjgp17X692081

American Psychiatric Association. (2014). Manual diagnóstico y estadístico de los trastornos mentales dsm-5. Editorial Médica Panamericana.

Bowring, D. L., Totsika, V., Hastings, R. P., Toogood, S., & McMahon, M. (2017). Prevalence of psychotropic medication use and association with challenging behaviour in adults with an intellectual disability. A total population study. Journal of Intellectual Disability Research, 61(6), 604-617. https://doi.org/10.1111/jir.12359

Branford, D., Gerrard, D., Saleem, N., Shaw, C., & Webster, A. (2019). Stopping over-medication of people with intellectual disability, Autism or both (stomp) in England part 1-history and background of stomp. Advances in Mental Health and Intellectual Disabilities, 13(1), 31- 40. http://dx.doi.org/10.1108/AMHID-02-2018-0004

Comité de Bioética de España. (2019). Informe del Comité de Bioética de España valorando el borrador de Protocolo Adicional al Convenio de Oviedo sobre Derechos Humanos y Biomedicina sobre la protección de los derechos humanos y la dignidad de las personas con trastornos mentales respecto a ingresos y tratamientos involuntarios. Comité de Bioética de España. http://assets.comitedebioetica.es/files/documentacion/ Informe%20valorando%20el%20Borrador%20del%20 Protocolo%20Adicional%20respecto%20a%20ingresos%20y%20tratamientos%20involuntarios.pdf

Deb, S., & Unwin, G. L. (2007). Psychotropic medication for behaviour problems in people with intellectual disability: A review of the current literature. Current Opinion in Psychiatry, 20(5), 461-466. http://dx.doi.org/10.1097/ YCO.0b013e3282ab9952

Deb, S., Unwin, G., & Deb, T. (2015). Characteristics and the trajectory of psychotropic medication use in general and antipsychotics in particular among adults with an intellectual disability who exhibit aggressive behaviour. Journal of Intellectual Disability Research, 59(1), 11-25. http://dx.doi.org/10.1111/jir.12119

De Kuijper, G. M., & Hoekstra, P. J. (2017). Physicians’ reasons not to discontinue long-term used off-label antipsychotic drugs in people with intellectual disability. Journal of Intellectual Disability Research, 61(10), 899- 908. http://dx.doi.org/10.1111/jir.12385

De Kuijper, G., & Van der Putten, A. A. J. (2017). Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 30(s1), 1-9. http://dx.doi. org/10.1111/jar.12357

Devandas, C. (2017, 14 de julio). Informe de la Relatora Especial sobre los derechos de las personas con discapacidad. Asamblea General Naciones Unidas. https://www. refworld.org.es/pdfid/59b6de1c4.pdf

Emerson, E., Kiernan, C., Alborz, A., Reeves, D., Mason, H., Swarbrick, R., Mason, L., & Hatton, C. (2001). The prevalence of challenging behaviors: A total population study. Research in Developmental Disabilities, 22(1), 77-93. https://doi.org/10.1016/S0891-4222(00)00061-5

Galindo-Domínguez, H. (2020). Estadística para no estadísticos: una guía básica sobre la metodología cuantitativa de trabajos académicos. Ciencias. Editorial Área de Innovación y Desarrollo. https://doi.org/10.17993/ EcoOrgyCso.2020.59

Holden, B., & Gitlesen, J. P. (2004). Psychotropic medication in adults with mental retardation: Prevalence, and prescription practices. Research in Developmental Disabilities, 25(6), 509-521. http://dx.doi.org/10.1016/j. ridd.2004.03.004

Horner, R. H., & Sugai, G. (2018). Future directions for positive behavior support: A commentary. Journal of Positive Behavior Interventions, 20(1), 19-22. https:// doi.org/10.1177/1098300717733977

Horner, R. H., Sugai, G., & Lewis, T. (2015). Is a school-wide positive behavior support an evidence-based practice. Positive Behavioral Interventions and Supports. https:// aztap.org/wp-content/uploads/2014/07/Daniel-Gulchak072017-Gulchak-Handout-1.pdf

IBM Corporation. (2017). ibm spss Statistics for Windows Versión 25.0. ibm Corporation.

Inchauspe, J. A. (2019). Actualidad en coerción y asistencia en salud mental: de la pugna declarativa al impulso a alternativas. Revista de la Asociación Española de Neuropsiquiatría, 39(136), 9-15. https://dx.doi. org/10.4321/s0211-57352019000200001

National Institute for Health and Care Excellence (nice). (2016). Mental health problems in people with learning disabilities: Prevention, assessment and management. nice guideline. https://www.nice.org.uk/guidance/ng54

Ji, N. Y., & Findling, R. L. (2016). Pharmacotherapy for mental health problems in people with intellectual disability. Current Opinion in Psychiatry, 29(2), 103-125. http://dx.doi.org/10.1097/YCO.0000000000000233

Jiménez, M., Aguilar, V., Pol, V., Mata, G., Crespo, S., Martínez, F., Carratalá, M., Pérez, E., & Pol, E. (2013). Seguimiento de las recomendaciones sobre psicofarmacología y su repercusión conductual en la discapacidad intelectual. Revista de la Asociación Española de Neuropsiquiatría, 33(119), 479-495. http://dx.doi.org/10.4321/S0211-5735 2013000300002

Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., Brown, T. A., Carpenter, W. T., Caspi, A., Clark, L. A., Eaton, N. R., Forbes, M. K., Forbush, K. T., Goldberg, D., Hasin, D., Hyman, S. E., Ivanova, M. Y., Lynam, D. R., Markon, K., … & Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (Hitop): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454-477. https://doi.org/10.1037/abn0000258

Lane, K. L., Menzies, H. M., Ennis, R. P., & Oakes, W. P. (2018). Effective low-intensity strategies to enhance school success: What every educator needs to Know. Beyond Behavior, 27(3), 128-133. https://doi. org/10.1177/1074295618799044

Lunsky, Y., Khuu, W., Tadrous, M., Vigod, S., Cobigo, V., & Gomes, T. (2018). Antipsychotic use with and without comorbid psychiatric diagnosis among adults with intellectual and developmental disabilities. The Canadian Journal of Psychiatry, 63(6), 361-369. http://dx.doi. org/10.1177/0706743717727240

Márquez-Caraveo, M. E., Zanabria-Salcedo, M., PérezBarrón, V., Aguirre-García, E., Arciniega-Buenrostro, L., & Galván-García, C. S. (2011). Epidemiología y manejo integral de la discapacidad intelectual. Salud Mental, 34(5), 443-449. http://www.scielo.org.mx/pdf/ sm/v34n5/v34n5a8.pdf

Marston, L., Nazareth, I., Petersen, I., Walters, K., & Osborn, D. P. (2014). Prescribing of antipsychotics in uk primary care: A cohort study. bmj Open, 4(12), Article e006135. http://dx.doi.org/10.1136/bmjopen-2014-006135

Matson, J. L., & Neal, D. (2009). Psychotropic medication use for challenging behaviors in persons with intellectual disabilities: An overview. Research in Developmental Disabilities, 30(3), 572-586. https://doi.org/10.1016/j. ridd.2008.08.007

McNamara, R., Randell, E., Gillespie, D., Wood, F., Felce, D., Romeo, R., Angel, L., Espinasse, A., Hood, K., Davies, A., Meek, A., Addison, K., Jones, G., Deslanses, P., Allen, D., Knapp, M., Thapar, A., & Kerr, M. (2017). A pilot randomised controlled trial of community-led ANtipsychotic Drug REduction for Adults with Learning Disabilities. Health Technology Assessment, 21(47), 1-92. https://doi. org/10.3310/hta21470

Moncrieff, J. (2013). Hablando claro: una introducción a los fármacos psiquiátricos. Herder.

Moncrieff, J. (2020). The past and future of psychiatry and its drugs. Psychotherapy Section Review, 65, 77- 83. https://discovery.ucl.ac.uk/10137711/3/Moncrieff_ The%20past%20and%20future%20of%20psychiatry%20and%20its%20drugs.pdf Niven, A.,

Goodey, R., Webb, A., & Shankar, R. (2018). The use of psychotropic medication for people with intellectual disabilities and behaviours that challenge in the context of a community multidisciplinary team approach. British Journal of Learning Disabilities, 46(1), 4-9. http://dx.doi.org/10.1111/bld.12206

O’Dwyer, M., Peklar, J., Mulryan, N., McCallion, P., McCarron, M., & Henman, M. C. (2017). Prevalence, patterns and factors associated with psychotropic use in older adults with intellectual disabilities in Ireland. Journal of Intellectual Disability Research, 61(10), 969- 983. http://dx.doi.org/10.1111/jir.12391

Observatorio Estatal de la Discapacidad. (2019). Estudio sobre la prevalencia de las alteraciones de la salud mental y/o problemas de conducta en las personas con discapacidad intelectual de Extremadura. sepad. https://saludextremadura.ses.es/sepad/publicationDetail?idItem=116602

Organización Mundial de la Salud. (2015). QualityRights: instrumento de calidad y derechos de la OMS: evaluando y mejorando la calidad y los derechos humanos en los establecimientos de salud mental y de apoyo social. Universidad de Chile, Facultad de Medicina; Escuela de Salud Pública Dr. Salvador Allende. https://apps.who. int/iris/handle/10665/150398 ONU:

Consejo de Derechos Humanos. (2017). Informe del Relator Especial sobre el derecho de toda persona al disfrute del más alto nivel posible de salud física y mental relativo a su visita a Croacia. Asamblea General de las Naciones Unidas. https://www.refworld.org.es/docid/59394ad74.html

Paton, C., Flynn, A., Shingleton-Smith, A., McIntyre, S., Bhaumik, S., Rasmussen, J., Hardy, S., & Barnes, T. (2011). Nature and quality of antipsychotic prescribing practice in uk psychiatry of intellectual disability services. Journal of Intellectual Disability Research, 55(7), 665-674. http://doi. org/10.1111/j.1365-2788.2011.01421.x

Perry, B. I., Cooray, S. E., Mendis, J., Purandare, K., Wijeratne, A., Manjubhashini, S., Dasari, M., Esan, F., Gunaratna, I., Naseem, R. A., Hoare, S., Chester, V., Roy, A., Devapriam, J., Alexander, R., & Kwok, H. F. (2018). Problem behaviours and psychotropic medication use in intellectual disability: A multinational cross-sectional survey. Journal of Intellectual Disability Research, 62(2), 140-149. http://dx.doi.org/10.1111/jir.12471

Ramerman, L., De Kuijper, G., Scheers, T., Vink, M., Vrijmoeth, P., & Hoekstra, P. J. (2019). Is risperidone effective in reducing challenging behaviours in individuals with intellectual disabilities after 1 year or longer use? A placebo-controlled, randomised, double-blind discontinuation study. Journal of Intellectual Disability Research, 63(5), 418-428. http://dx.doi.org/10.1111/ jir.12584

Ramerman, L., Hoekstra, P. J., & Kuijper, G. (2018). Healthrelated quality of life in people with intellectual disability who use long-term antipsychotic drugs for challenging behavior. Research in Developmental Disabilities, 75, 49-58. https://doi.org/10.1016/j.ridd.2018.02.011

Ramerman, L., Hoekstra, P. J., & De Kuijper, G. (2019). Changes in health-related quality of life in people with intellectual disabilities who discontinue long-term used antipsychotic drugs for challenging behaviors. Journal of Clinical Pharmacology, 59(2), 280-287. http://dx.doi. org/10.1002/jcph.1311

Read, J., & Williams, J. (2019). Positive and negative effects of antipsychotic medication: An international online survey of 832 recipients. Current Drug Safety, 14(3), 173- 181. http://dx.doi.org/10.2174/15748863146661903011 52734

Royal College of Psychiatrists. (2016). Psychotropic drug prescribing for people with intellectual disability, mental health problems and/or behaviors that challenge: Practice guidelines. Faculty of Psychiatry of Intellectual Disability. https://www.rcpsych.ac.uk/docs/ default-source/members/faculties/intellectual-disability/id-fr-id-095701b41885e84150b11ccc989330357c. pdf?sfvrsn=55b66f2c_4

Rueda, P., & Novell, R. (2021). Conductas que nos preocupan en personas con discapacidad intelectual y del desarrollo: ¿Qué debes saber? ¿Qué debes hacer? Plena inclusión. https://www.plenainclusion.org/publicaciones/buscador/conductas-que-nos-preocupan-en-personas-con-discapacidad-intelectual-y-del-desarro llo-que-debes-saber-que-debes-hacer/

Salvador-Carulla, L., & Novell, R. (2012). Problemas de conducta en el retraso mental. Siglo Cero, 34(2), 78-86. http://hdl.handle.net/11181/3065

San Román, A., Martínez, B., González, B., Araoz, I. D., Espejo, L., Ambros, N., Tendero, R., Reyes, S., & Fernández, M. (2021). Apoyos 2030. Un viaje para avanzar hacia apoyos personalizados y en la comunidad. Plena Inclusión.

Sandín, B., Chorot, P., & Valiente, R. M. (2012). Transdiagnóstico: nueva frontera en psicología clínica. Revista de Psicopatología y Psicología Clínica, 17(3), 185-203. https://doi.org/10.5944/rppc.vol.17. num.3.2012.11839

Sheehan, R., & Hassiotis, A. (2017). Reduction or discontinuation of antipsychotics for challenging behaviour in adults with intellectual disability: A systematic review. Lancet Psychiatry, 4(3), 238-256. http://dx.doi. org/10.1016/S2215-0366(16)30191-2

Sheehan, R., Hassiotis, A., Walters, K., Osborn, D., Strydom, A., & Horsfall, L. (2015). Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: uk population-based cohort study. bmj, 351, Article h4326. https://doi.org/10.1136/ bmj.h4326

Singh, A. N., & Matson, J. L. (2009). An examination of psychotropic medication prescription practices for individuals with intellectual disabilities. Journal of Developmental and Physical Disabilities, 21(2), 115- 129. http://dx.doi.org/10.1007/s10882-008-9129-1

Steege, M. W., Pratt, J. L., Wickerd, G., Guare, R., & Watson, T. S. (2019). Conducting school-based functional behavioral assessments. A practitioner’s guide (3th ed.). The Guilford Press.

Tsiouris, J. A. (2010). Pharmacotherapy for aggressive behaviours in persons with intellectual disabilities: Treatment or mistreatment? Journal of Intellectual Disability Research, 54(1), 1-16. http://dx.doi. org/10.1111/j.1365-2788.2009.01232.x

Tyrer, P., Oliver-Africano, P. C., Ahmed, Z., Bouras, N., Cooray, S., Deb, S., Murphy, D., Hare, M., Meade, M., Reece, B., Kramo, K., Bhaumik, S., Harley, D., Regan, A., Thomas, D., Rao, B., North, B., Eliahoo, J., Karatela, S.,… & Crawford, M. D. (2008). Risperidone, haloperidol, and placebo in the treatment of aggressive challenging behaviour in patients with intellectual disability: A randomised controlled trial. Lancet, 371(9606), 57-63. http://dx.doi.org/10.1016/S0140-6736(08)60072-0

Villamarín, S., & De Vicente, A. (2019). El Comité de Bioética de España pide suprimir los internamientos y tratamientos involuntarios por trastorno mental. Infocop, 87, 26-27. http://www.infocop.es/view_article. asp?id=8370

##submission.citations.for##

Most read articles by the same author(s)

Sistema OJS 3 - Metabiblioteca |