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Chapter 370of work-related social services, resulting in an underrepresentation of older people. Finally, the database contains no exact information on intellectual and adaptive functioning on an individual level, so it cannot be ruled out that some people with more severe ID or borderline intelligence were included in our MID group. However, the SN-MID database is currently the most complete method available in the Netherlands to identify people with MID. Comparison with existing literatureIn our study, 25.3% of the people with MID had an MH disorder. This is comparable to Sheehan et al.’s primary care cohort study, 2 which found a point prevalence of 21% in people with any form of ID. Our incorporation of MH complaints has not been studied before in primary care. The high prevalence of psychosis in MID (4.2%) we found was also observed in other primary care studies. 5, 17 We found a higher prevalence of substance abuse in people with MID compared to people without ID. A systematic review, that did not include primary care settings, concluded that people with MID are at high risk of developing substance use disorder.18 The striking relatively high prevalence of ‘suicide/suicide attempt’ (P77) and unspecified ICPC-P codes (P29, P99) has not been previously reported in primary care studies. However, Dodd et al.’s systematic review of suicidality in people with ID revealed that the presence of having an MH disorder is seen as an important risk factor for suicide in these patients.19 More importantly, it shows a lack of well-designed studies on suicide in people with ID, and there are limited ID-specific assessments or therapeutic interventions for suicidality.The absence of a P85 code for the vast majority of people with MID is in line with previous research. 10 The relatively high prevalence of the ICPC codes ‘limited function/disability’ (P28) and ‘specific learning problems’ (P24) in people with MID in this study could indicate that these codes are used as a substitute for P85.The higher number of GP consultations, home visits, and telephone consultations for people with MID and MH problems is in line with earlier research on people with ID in general in primary care. 17, 20, 21 The relatively Katrien Pouls sHL.indd 70 24-06-2024 16:26