background  Little is known about the link between psychiatric symptoms and psychotropic drug use among the mentally retarded in residential care.
aim We wanted to gain insight into the use of psychotropic drugs by mentally retarded persons with psychiatric symptoms residing in care homes.
method  Nursing staff in these homes selected 573 problematic residents (one resident from each home) and 1479 residents were randomly sampled from all the homes. Psychiatric symptoms were measured using the Reiss Screen for Maladaptive Behavior and the Psychopathology Instrument for Mentally Retarded Adults.
results  Psychotropics (excluding anticonvulsants) were used by 52.6% of the problem behaviour group and by 22.8% of the randomly sampled group. Young age, psychotic, anxiety and aggression symptoms were significantly associated with the problem group as were the use of antipsychotics and antidepressants. Antidepressants or mood stabilisers, antipsychotics and anxiolytics were relatively sparsely administered to patients with affective, psychotic, or anxiety symptoms.
conclusion  Antipsychotics in particular are prescribed frequently. Furthermore, it is likely that a considerable number of residents with psychiatric symptoms receive less treatment than they actually require.