Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis

Koslowski, Nadine; Klein, Kristina; Arnold, Katrin; Kösters, Markus; Schützwohl, Matthias; Salize, Hans Joachim; Puschner, Bernd

doi:10.1192/bjp.bp.114.162313

Cited by 80 publications

(66 citation statements)

References 38 publications

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“…The reference lists of recent systematic reviews (Flynn ; Sturmey ; Chen ; Hwang & Kearney ; Matson ; Vereenooghe & Langdon ; Jennings & Hewitt ; Koslowski et al . ; Maber‐Aleksandrowicz et al . ; Osugo & Cooper ; Unwin et al .…”

Section: Resultsmentioning

confidence: 99%

“…Koslowski et al . () investigated in their systematic review and meta‐analyses the effectiveness of interventions on mental health problems in adults with mild to moderate ID. They found no strong evidence for interventions aimed at improving mental health problems, including depression, and found a non‐significant moderate effect size [ d = 0.49, 95% confidence interval (CI)‐0.05 to 1.03; P = 0.08] for depression interventions (psychotherapy only).…”

Section: Introductionmentioning

confidence: 99%

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Non‐pharmacological interventions for adults with intellectual disabilities and depression: a systematic review

Hamers

Festen

Hermans

2018

J intellect Disabil Res

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non‐pharmacological interventions for adults with intellectual disabilities and depression: a systematic review

Hamers

Festen

Hermans

2018

J intellect Disabil Res

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“…those with both low IQ and mental health problems early, and consider intervening on this high-risk group to increase integration into the labour market. Although there is no compelling evidence supporting interventions aiming at improving mental health problems in people with mild to moderate intellectual disability, there are some promising interventions that could be evaluated further in larger trials[42]. Targeted support and interventions to help cope with mental health problems and interventions like work-focused CBT and individual job support may increase work participation and prevent later adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

IQ and mental health are vital predictors of work drop out and early mortality. Multi-state analyses of Norwegian male conscripts

et al. 2017

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BackgroundDisability benefits and sick leave benefits represents huge costs in western countries. The pathways and prognostic factors for receiving these benefits seen in recent years are complex and manifold. We postulate that mental health and IQ, both alone and concurrent, influence subsequent employment status, disability benefits and mortality.MethodsA cohort of 918 888 Norwegian men was followed for 16 years from the age of 20 to 55. Risk for health benefits, emigration, and mortality were studied. Indicators of mental health and IQ at military enrolment were used as potential risk factors. Multi-state models were used to analyze transitions between employment, sick leave, time limited benefits, disability benefits, emigration, and mortality.ResultsDuring follow up, there were a total of 3 908 397 transitions between employment and different health benefits, plus 12 607 deaths. Men with low IQ (below 85), without any mental health problems at military enrolment, had an increased probability of receiving disability benefits before the age of 35 (HRR = 4.06, 95% CI: 3.88–4.26) compared to men with average IQ (85 to 115) and no mental health problems. For men with both low IQ and mental health problems, there was an excessive probability of receiving disability benefits before the age of 35 (HRR = 14.37, 95% CI: 13.59–15.19), as well as an increased probability for time limited benefits and death before the age of 35 compared to men with average IQ (85 to 115) and no mental health problems.ConclusionLow IQ and mental health problems are strong predictors of future disability benefits and early mortality for young men.

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“…Most people with ID and co‐morbid mental health issues will not receive specialist treatment (Einfeld & Tonge, ; McCarthy & Boyd, ). Anxiety disorders are common (Bailey & Andrews, ; Cooper, ; Cooper, Smiley, Morrison, Williamson, & Allan, ; Deb, Thomas, & Bright, ) and do not typically remit without intervention (Tonge & Einfeld, ), yet evidence‐based psychological treatments for anxiety disorders in people with ID are lacking (Koslowski et al, ; Osugo & Cooper, ; Unwin, Tsimopoulou, Kroese, & Azmi, ; Vereenooghe & Langdon, ). Research suggests that adults with predominately mild ID can benefit from psychological treatments such as cognitive behaviour therapy (CBT; Osugo & Cooper, ), particularly for depression and anger difficulties (Vereenooghe & Langdon, ); however, the evidence base is still in a nascent stage.…”

Section: Introductionmentioning

confidence: 99%

Putting the C into CBT: Cognitive challenging with adults with mild to moderate intellectual disabilities and anxiety disorders

Roberts

Kwan

2018

Clin Psychology and Psychoth

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Individuals with intellectual disabilities (ID) are more vulnerable to mental health difficulties than the general population, yet there are limited evidence-based treatments available for this group. There has been a growing interest in adapting cognitive behaviour therapy (CBT) for this population; however, a framework describing how to modify cognitive challenging for a group characterized by cognitive impairment is lacking. The aim of this paper is threefold: (a) to describe how to implement cognitive challenging for adults with ID; (b) to report results from a pilot evaluation of a manualized, modified CBT-ID programme for anxiety; and (c) to compare participants with mild versus moderate ID on post-treatment cognitive challenging competencies. Results showed that the broad CBT-ID programme significantly reduced anxiety in adults with ID as measured by self, informant, and clinician ratings. In addition, adults with mild but not moderate ID demonstrated competence across a range of specific cognitive challenging skills following treatment. These findings contribute to the growing evidence base for the use of CBT with people with ID. In addition, the framework described offers practitioners specific therapeutic methods to effectively challenge maladaptive thoughts that maintain anxiety in this population.

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Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis

Cited by 80 publications

References 38 publications

Non‐pharmacological interventions for adults with intellectual disabilities and depression: a systematic review

Non‐pharmacological interventions for adults with intellectual disabilities and depression: a systematic review

IQ and mental health are vital predictors of work drop out and early mortality. Multi-state analyses of Norwegian male conscripts

Putting the C into CBT: Cognitive challenging with adults with mild to moderate intellectual disabilities and anxiety disorders

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