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

Leen Vereenooghe, Samantha Flynn, Richard P Hastings, Dawn Adams, Umesh Chauhan, Sally-Ann Cooper, Nick Gore, Chris Hatton, Kerry Hood, Andrew Jahoda, Peter E Langdon, Rachel McNamara, Chris Oliver, Ashok Roy, Vasiliki Totsika, Jane Waite

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment 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 or pre-post design.

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 five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two 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, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities.

PROSPERO REGISTRATION NUMBER: CRD 42015024469.

Original languageEnglish
Article numbere021911
JournalBMJ Open
Volume8
Issue number6
DOIs
Publication statusPublished - 19 Jun 2018

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Intellectual Disability
Mental Health
Pharmacology
Psychology
Therapeutics
Social Sciences
Drug-Related Side Effects and Adverse Reactions
MEDLINE
Cross-Over Studies
Research Design
Placebos
Research Personnel
Population

Bibliographical note

This is an open access article distributed in accordance with the
Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-commercially,
and license their derivative works on different terms, provided the original work is
properly cited and the use is non-commercial. See: http:// creativecommons. org/
licenses/ by- nc/ 4. 0/
© Article author(s) (or their employer(s) unless otherwise stated in the text of the
article) 2018. All rights reserved. No commercial use is permitted unless otherwise
expressly granted.

Cite this

Vereenooghe, Leen ; Flynn, Samantha ; Hastings, Richard P ; Adams, Dawn ; Chauhan, Umesh ; Cooper, Sally-Ann ; Gore, Nick ; Hatton, Chris ; Hood, Kerry ; Jahoda, Andrew ; Langdon, Peter E ; McNamara, Rachel ; Oliver, Chris ; Roy, Ashok ; Totsika, Vasiliki ; Waite, Jane. / Interventions for mental health problems in children and adults with severe intellectual disabilities: A systematic review. In: BMJ Open. 2018 ; Vol. 8, No. 6.
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Vereenooghe, L, Flynn, S, Hastings, RP, Adams, D, Chauhan, U, Cooper, S-A, Gore, N, Hatton, C, Hood, K, Jahoda, A, Langdon, PE, McNamara, R, Oliver, C, Roy, A, Totsika, V & Waite, J 2018, 'Interventions for mental health problems in children and adults with severe intellectual disabilities: A systematic review', BMJ Open, vol. 8, no. 6, e021911. https://doi.org/10.1136/bmjopen-2018-021911

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; Hatton, Chris; Hood, Kerry; Jahoda, Andrew; Langdon, Peter E; McNamara, Rachel; Oliver, Chris; Roy, Ashok; Totsika, Vasiliki; Waite, Jane.

In: BMJ Open, Vol. 8, No. 6, e021911, 19.06.2018.

Research output: Contribution to journalArticle

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T1 - Interventions for mental health problems in children and adults with severe intellectual disabilities: A systematic review

AU - Vereenooghe, Leen

AU - Flynn, Samantha

AU - Hastings, Richard P

AU - Adams, Dawn

AU - Chauhan, Umesh

AU - Cooper, Sally-Ann

AU - Gore, Nick

AU - Hatton, Chris

AU - Hood, Kerry

AU - Jahoda, Andrew

AU - Langdon, Peter E

AU - McNamara, Rachel

AU - Oliver, Chris

AU - Roy, Ashok

AU - Totsika, Vasiliki

AU - Waite, Jane

N1 - This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons. org/ licenses/ by- nc/ 4. 0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/6/19

Y1 - 2018/6/19

N2 - OBJECTIVE: Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment 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 or pre-post design.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 five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two 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, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities.PROSPERO REGISTRATION NUMBER: CRD 42015024469.

AB - OBJECTIVE: Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment 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 or pre-post design.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 five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two 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, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities.PROSPERO REGISTRATION NUMBER: CRD 42015024469.

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DO - 10.1136/bmjopen-2018-021911

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VL - 8

JO - BMJ Open

JF - BMJ Open

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