Health-related quality of life in people with intellectual disability who use long-term antipsychotic drugs for challenging behaviour.
Use HQoL tools to check if antipsychotic side-effects are making life worse before you keep the pills going.
01Research in Context
What this study did
Lotte et al. asked the adults with intellectual disability to fill out two short quality-of-life forms. All of them had taken antipsychotic pills every day for at least one year to control challenging behaviour.
The team also scored each person’s irritability, lethargy, and physical side-effects like weight gain or shakes. They wanted to see if these problems dragged down the person’s day-to-day well-being.
What they found
Higher irritability and more drug side-effects both predicted lower health-related quality of life. In plain words, when the medicine made them tired, restless, or heavy, life felt worse.
The authors say quality-of-life scores should sit beside behaviour charts when doctors decide whether to keep the pills.
How this fits with other research
Green et al. (2020) found that staff turnover and under-funding also spark challenging behaviour. Lotte’s work adds: even after drugs calm the behaviour, side-effects can still hurt the person’s lived experience.
Ahrens et al. (2011) cut aggression to near-zero using peer-taught mindfulness instead of pills. Their success hints that non-drug routes can protect quality of life without the medical baggage Lotte measured.
Llanes et al. (2020) showed teacher conflict worsens depression in students with ID. Together these papers map a chain: environment → mood or side-effects → quality of life.
Why it matters
Before you renew a long-term antipsychotic prescription, pull out a HQoL tool like RAND-36 or POS. A quick 10-minute survey can show if side-effects are quietly eroding the same well-being the drug is meant to protect. If scores are low, team up with the doctor to taper, switch, or add behavioural supports first.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add the two HQoL questions to your intake packet and review them at the next psychiatrist check-in.
02At a glance
03Original abstract
BACKGROUND: Many people with intellectual disabilities use long-term antipsychotics for challenging behaviour and experience side-effects from these drugs, which may affect Health-related Quality of Life (HQoL). AIMS: This study aimed to investigate HQoL in people with intellectual disabilities who use long-term antipsychotics and to investigate its associations with challenging behaviour and physical symptoms often associated with antipsychotics. MATERIALS AND METHODS: We used baseline data of two studies of long-term used antipsychotics. The RAND-36 and the emotional and physical wellbeing subscales of the Personal Outcome Scale (POS) were used to assess HQoL. Associations with challenging behaviour, measured with the Aberrant Behavior Checklist (ABC) and physical symptoms (extrapyramidal, autonomic, metabolic) with HQoL outcomes were analysed by univariate and multivariate linear regression. RESULTS: The mental subscales of the RAND-36 and emotional wellbeing of the POS were associated with the irritability and lethargy ABC-subscales. Physical wellbeing was negatively associated with parkinsonism urinary problems, dysphagia and temperature dysregulation possibly due to antipsychotics use. CONCLUSION: Both mental and physical wellbeing are related to challenging behaviour and physical symptoms associated with antipsychotics. Therefore HQoL could be a helpful measure when balancing benefits and disadvantages of antipsychotics prescribed for challenging behaviour.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.02.011