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Updated: Sep 9, 2025

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Neuropsychiatric Disorders Among Adult Emergency Department Patients With Intellectual and Developmental

Harold A Pollack1,2, Brandon Tabman3, Derek S Brown4

  • 1Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago.

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Summary

Adults with intellectual and developmental disabilities (IDDs) have higher rates of emergency department visits for mental and neurologic disorders, including suicidality, seizures, and dementia.

Keywords:
DementiaDown’s SyndromeEmergency PsychiatryIntellectual and Developmental DisabilitiesMental DisordersNeuropsychiatry/Neurobiology

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Public Health

Background:

  • Individuals with intellectual and developmental disabilities (IDDs) often have complex health needs.
  • Understanding the prevalence of psychiatric and neurologic conditions in this population is crucial for targeted healthcare.
  • Emergency department (ED) visits provide a valuable data source for assessing these health disparities.

Purpose of the Study:

  • To compare the rates of psychiatric and neurologic diagnoses in emergency department (ED) visits between adults with and without intellectual and developmental disabilities (IDDs).
  • To identify specific conditions that are disproportionately represented in the ED population with IDDs.

Main Methods:

  • A cross-sectional study utilizing the 2019 Nationwide Emergency Department Sample (NEDS) of U.S. hospital ED visits.
  • Validated diagnostic codes were employed to identify psychiatric and neurologic conditions in adults (≥18 years) with and without diagnosed IDDs.
  • Key conditions analyzed included depression, anxiety, psychosis, suicidality, seizure, dementia, and sleep disorders.

Main Results:

  • Adults with IDDs accounted for 558,408 ED visits, compared to 112,593,527 for those without IDDs.
  • Individuals with IDDs were twice as likely to have a mental disorder as the principal ED diagnosis.
  • Significantly higher rates of suicidality (1.6x), neurologic disorders (5.6x), and seizures (8.1x) were observed in adults with IDDs. Dementia rates were nearly double, and notably higher in individuals with Down syndrome.

Conclusions:

  • Adult emergency department patients with IDDs exhibit a higher likelihood of co-occurring mental and neurologic disorders compared to the general population.
  • These findings highlight the critical need for accessible, lifelong neuropsychiatric services tailored to the unique requirements of individuals with IDDs.
  • Addressing these disparities is essential for improving health outcomes and quality of life for individuals with IDDs.