Neuropsychiatric Disorders Among Adult Emergency Department Patients With Intellectual and Developmental Disabilities

This study aimed to compare rates of psychiatric and neurologic diagnoses on emergency department (ED) visit records of adults with versus without intellectual and developmental disabilities (IDDs).

This cross-sectional study used the 2019 Nationwide Emergency Department Sample of U.S. hospital ED visit discharges. Validated codes were used to compare psychiatric and neurologic diagnoses of patients ages ≥18 with versus without diagnosed IDDs. Diagnosed psychiatric and neurologic conditions included depression, anxiety, schizophrenia or psychosis, suicidality, seizure, dementia, and sleep disorder.

The analysis identified 558,408 and 112,593,527 (nationally weighted) ED visits by adults with and without IDDs, respectively. Compared with the general population, adults with IDDs were twice as likely to have a mental disorder as the principal visit diagnosis, with higher probabilities of principal visit suicidality (1.6 times higher), neurologic disorder (5.6 times higher), and seizure (8.1 times higher) diagnoses. Compared with the general population, adults with intellectual disability were nearly twice as likely to have a dementia diagnosis, and patients with Down's syndrome were six times likelier to have a dementia diagnosis. More than one in five ED visit records of patients ages 50-54 with Down's syndrome included a dementia diagnosis; the dementia diagnosis rate for such patients ages ≥70 was 2.7 times higher than that of the general population.

Adult ED patients with IDDs were more likely than those without IDDs to have co-occurring mental and neurologic disorders. Findings underscore the need to provide neuropsychiatric services across the lifespan to address the distinctive care needs of individuals with IDDs.