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Interventions for mental health problems in children and adults with severe intellectual disabilities: A systematic review

Vereenooghe, Leen, Flynn, Samantha, Hastings, Richard P., Adams, Dawn, Chauhan, Umesh, Cooper, Sally-Ann, Gore, Nick J., Hatton, Chris, Hood, Kerry, Jahoda, Andrew, and others. (2018) Interventions for mental health problems in children and adults with severe intellectual disabilities: A systematic review. BMJ Open, 8 . pp. 1-12. ISSN 2044-6055. (doi:10.1136/bmjopen-2018-021911)

Abstract

Objective: Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatments options have received little attention. The aim of this study was to identify and evaluate the effectiveness of pharmacological and psychological interventions in the treatment of mental health problems in children and adults with severe and profound intellectual disabilities, given their difficulties in accessing standard mental health interventions, particularly talking-therapies, and difficulties reporting drug side-effects.

Design: A systematic review using electronic searches of PsycINFO, PsycTESTS, EMBASE, MEDLINE, CINAHL, ERIC, ASSIA, Science Citation Index, Social Science Citation Index, and CENTRAL was conducted to identify eligible intervention studies. Study selection, data extraction and quality appraisal were performed by two independent reviewers.

Participants: Study samples included at least 70 % children and/or adults with severe or profound intellectual disabilities or reported the outcomes of this subpopulation separate from participants with other levels of intellectual disabilities.

Interventions: Eligible intervention studies evaluated a psychological or pharmacological intervention using a control condition.

Outcomes: Symptom severity, frequency or other quantitative dimension (e.g., impact), as assessed with standardised measures of mental health problems.

Results: We retrieved 41,232 records, reviewed 573 full-text articles and identified 5 studies eligible for inclusion: 3 studies evaluating pharmacological interventions, and 2 studies evaluating psychological interventions. Study designs ranged from double-blind placebo-controlled crossover trials to single-case experimental reversal designs. Quality appraisals of this very limited literature base revealed good experimental control, poor reporting standards, and a lack of follow-up data.

Conclusions: Mental ill-health requires vigorous treatment, yet the current evidence base is too limited to identify with precision effective treatments specifically for children or adults with severe and profound intellectual disabilities. Clinicians therefore must work on the basis of general population evidence, whilst researchers

Item Type: Article
DOI/Identification number: 10.1136/bmjopen-2018-021911
Uncontrolled keywords: intellectual disability, mental health, systematic review, psychological therapies, pharmacotherapies
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Tizard
Depositing User: Peter Langdon
Date Deposited: 04 Jun 2018 08:50 UTC
Last Modified: 22 Jul 2019 13:55 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/67191 (The current URI for this page, for reference purposes)
Langdon, Peter E.: https://orcid.org/0000-0002-7745-1825
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