title: Substance-related and addictive disorders among adults with intellectual and developmental disabilities (IDD): an Ontario population cohort study.
abstract: Describe the prevalence of substance-related and addictive disorders (SRAD) in adults with intellectual and developmental disabilities (IDD) and compare the sociodemographic and clinical characteristics of adults with IDD and SRAD to those with IDD or SRAD only.
  
  
  
  Population-based cohort study (the Health Care Access Research and Development Disabilities (H-CARDD) cohort).
  
  
  
  All legal residents of Ontario, Canada.
  
  
  
  66 484 adults, aged 18-64, with IDD identified through linked provincial health and disability income benefits administrative data from fiscal year 2009. 96 589 adults, aged 18-64, with SRAD but without IDD drawn from the provincial health administrative data.
  
  
  
  Sociodemographic (age group, sex, neighbourhood income quintile, rurality) and clinical (psychiatric and chronic disease diagnoses, morbidity) characteristics.
  
  
  
  The prevalence of SRAD among adults with IDD was 6.4%, considerably higher than many previous reports and also higher than found for adults without IDD in Ontario (3.5%). Among those with both IDD and SRAD, the rate of psychiatric comorbidity was 78.8%, and the proportion with high or very high overall morbidity was 59.5%. The most common psychiatric comorbidities were anxiety disorders (67.6%), followed by affective (44.6%), psychotic (35.8%) and personality disorders (23.5%). These adults also tended to be younger and more likely to live in the poorest neighbourhoods compared with adults with IDD but no SRAD and adults with SRAD but no IDD.
  
  
  
  SRAD is a significant concern for adults with IDD. It is associated with high rates of psychiatric and other comorbidities, indicating that care coordination and system navigation may be important concerns. Attention should be paid to increasing the recognition of SRAD among individuals with IDD by both healthcare and social service providers and to improving staff skills in successfully engaging those with both IDD and SRAD.
authors: Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors: Elizabeth
authors: E
authors: Lin
authors: Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.
authors: Robert
authors: R
authors: Balogh
authors: Cancer Care Ontario, Toronto, Ontario, Canada.
authors: Caitlin
authors: C
authors: McGarry
authors: Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors: Avra
authors: A
authors: Selick
authors: Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.
authors: Kristin
authors: K
authors: Dobranowski
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: Andrew S
authors: AS
authors: Wilton
authors: Underserved Populations Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors: Yona
authors: Y
authors: Lunsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016739:Behavior, Addictive / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D002658:Developmental Disabilities / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications* / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity; D009864:Ontario / Q000453:epidemiology; D011203:Poverty; D015995:Prevalence; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
keywords: MENTAL HEALTH