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Journal of the American Academy of... Sep 2020The behavioral phenotype of neurogenetic disorders associated with intellectual disability often includes psychiatric comorbidity. The objectives of this systematic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The behavioral phenotype of neurogenetic disorders associated with intellectual disability often includes psychiatric comorbidity. The objectives of this systematic review and meta-analysis were to systematically review the prevalence of psychiatric disorders and symptoms in children and adolescents with these disorders and compare phenotypic signatures between syndromes.
METHOD
MEDLINE and PsycINFO databases were searched for articles from study inception to December 2018. Eligible articles were peer reviewed, were published in English, and reported prevalence data for psychiatric disorders and symptoms in children and adolescents aged 4 to 21 years using a formal psychiatric assessment or a standardized assessment of mental health symptoms. Pooled prevalence was determined using a random-effects meta-analysis in studies with sufficient data. Prevalence estimates were compared with general population data using a test of binomial proportions.
RESULTS
Of 2,301 studies identified for review, 39 articles were included in the final pool, which provided data on 4,039 children and adolescents. Ten syndromes were represented, and five were predominant: Down syndrome, 22q11.2 deletion syndrome, fragile X syndrome, Williams syndrome, and Prader-Willi syndrome. The Child Behavior Checklist was the most commonly used assessment tool for psychiatric symptoms. The pooled prevalence with total scores above the clinical threshold was lowest for Down syndrome (32% [95% confidence interval, 19%-44%]) and highest for Prader-Willi syndrome (74% [95% CI, 65%-82%]) with each syndrome associated with significantly higher prevalence than in the general population. Parallel trends were observed for the internalizing and externalizing domains and social subscale scores.
CONCLUSION
Differential vulnerability for psychiatric phenotype expression across the disorders was observed. Syndromes with higher levels of social ability or competence appear to offer relative protection against developing psychopathology. This preliminary finding merits further exploration.
Topics: Adolescent; Adult; Child; Child, Preschool; Comorbidity; Humans; Intellectual Disability; Mental Disorders; Mental Health; Prader-Willi Syndrome; Prevalence; Young Adult
PubMed: 31945412
DOI: 10.1016/j.jaac.2020.01.006 -
Journal of Intellectual & Developmental... Jun 2011Mental disorder and intellectual disability each accounts for substantial burden of disease. However, the extent of this co-occurrence varies substantially between... (Review)
Review
BACKGROUND
Mental disorder and intellectual disability each accounts for substantial burden of disease. However, the extent of this co-occurrence varies substantially between reports. We sought to determine whether studies in children and/or adolescents with acceptably rigorous methods can be distinguished from existing reports, and whether key risk factors could be ascertained.
METHOD
Published studies investigating the prevalence of mental disorders in children and/or adolescents with intellectual disability were reviewed.
RESULTS
Nine studies with acceptable methods were identified, 4 which compared the prevalence of mental disorder in populations of those with and without intellectual disability, and a further 5 studies that estimated the rates of mental disorder in those with intellectual disability were identified. Collectively, these studies demonstrate rates of comorbidity for children and adolescents between 30 and 50% with a relative risk of mental disorder associated with intellectual disability ranging from 2.8-4.5. The risks for this comorbidity associated with age, gender, severity of intellectual disability, and socioeconomic status remain uncertain.
CONCLUSIONS
Appreciation of this comorbidity needs to be a fundamental component of both mental health and intellectual disability services.
Topics: Adolescent; Age Distribution; Child; Comorbidity; Humans; Intellectual Disability; Mental Disorders; Prevalence; Risk; Risk Factors; Severity of Illness Index; Sex Factors; Social Class
PubMed: 21609299
DOI: 10.1080/13668250.2011.572548 -
Journal of Intellectual Disability... Jun 2016People with intellectual disabilities have very high rates of mental ill health. Standard psychosocial interventions designed for the general population may not be... (Review)
Review
BACKGROUND
People with intellectual disabilities have very high rates of mental ill health. Standard psychosocial interventions designed for the general population may not be accessible for people with mild intellectual disabilities, and drug usage tends to be modified - 'start low and go slow'. This systematic review aims to synthesise the evidence on psychological, pharmacological and electroconvulsive therapy (ECT) interventions for adults with mild intellectual disabilities and mental ill health.
METHOD
PRISMA guidelines were followed. Medline, Embase, PsycINFO and CINAHL were searched, as was grey literature and reference lists of selected papers. Papers were selected based on pre-defined inclusion and exclusion criteria. A proportion of papers were double reviewed. Data was extracted using a structured table.
STUDY REGISTRATION
PROSPERO 2015:CRD42015015218.
RESULTS
Initially, 18 949 records were identified. Sixteen studies were finally selected for inclusion; seven on psychological therapies, two on group exercise, five on antipsychotics and two on antidepressants. They do not provide definitive evidence for effectiveness of psychosocial interventions, nor address whether starting low and going slow is wise, or causes sub-optimum therapy.
CONCLUSIONS
There are few evidence-based interventions for people with mild intellectual disabilities and mental ill-health; existing literature is limited in quantity and quality. Group cognitive-behavioural therapies have some supporting evidence - however, further randomised control trials are required, with longer-term follow-up, and larger sample sizes.
Topics: Comorbidity; Humans; Intellectual Disability; Mental Disorders
PubMed: 27109143
DOI: 10.1111/jir.12285 -
Developmental Medicine and Child... Jan 2018Mental health conditions and problems are often reported in children and adolescents with cerebral palsy (CP). A systematic review was undertaken to describe their... (Meta-Analysis)
Meta-Analysis Review
AIM
Mental health conditions and problems are often reported in children and adolescents with cerebral palsy (CP). A systematic review was undertaken to describe their prevalence.
METHOD
MEDLINE and PsycINFO databases from 1996 to 2016 were searched and reference lists of selected studies were reviewed. Studies were included if they reported point prevalence of mental health diagnoses or symptoms in a general population of children and/or adolescents with CP. Pooled prevalence for mental health symptoms was determined using a random effects meta-analysis.
RESULTS
Of the 3158 studies identified, eight met the inclusion criteria. Mental health disorders were diagnosed by psychiatric interview in one study, giving a prevalence of 57% (32 out of 56 children). The remaining seven studies (n=1715 children) used parent-report mental health screening tools. The pooled prevalence for mental health symptoms using the Strengths and Difficulties Questionnaire (n=5 studies) was 35% (95% confidence interval [CI] 20-61) and using the Child Behavior Checklist (n=2 studies) was 28% (95% CI 22-36). Evidence was characterized by a moderate level of bias.
INTERPRETATION
More studies are needed to ascertain the prevalence of mental health disorders. Mental health symptoms are common and mental health evaluations should be incorporated into multidisciplinary assessments for these children.
WHAT THIS PAPER ADDS
Children with cerebral palsy and intellectual disability have a higher risk of mental health symptoms. The prevalence of mental health symptoms for age and severity groups is unclear.
Topics: Adolescent; Cerebral Palsy; Child; Comorbidity; Humans; Intellectual Disability; Mental Disorders
PubMed: 28914445
DOI: 10.1111/dmcn.13555 -
Genetics in Medicine : Official Journal... Mar 2009Array-based comparative genomic hybridization is being increasingly used in patients with learning disability (mental retardation) and congenital anomalies. In this... (Meta-Analysis)
Meta-Analysis Review
Array CGH in patients with learning disability (mental retardation) and congenital anomalies: updated systematic review and meta-analysis of 19 studies and 13,926 subjects.
Array-based comparative genomic hybridization is being increasingly used in patients with learning disability (mental retardation) and congenital anomalies. In this article, we update our previous meta-analysis evaluating the diagnostic and false-positive yields of this technology. An updated systematic review and meta-analysis was conducted investigating patients with learning disability and congenital anomalies in whom conventional cytogenetic analyses have proven negative. Nineteen studies (13,926 patients) were included of which 12 studies (13,464 patients) were published since our previous analysis. The overall diagnostic yield of causal abnormalities was 10% (95% confidence interval: 8-12%). The overall number needed to test to identify an extra causal abnormality was 10 (95% confidence interval: 8-13). The overall false-positive yield of noncausal abnormalities was 7% (95% confidence interval: 5-10%). This updated meta-analysis provides new evidence to support the use of array-based comparative genomic hybridization in investigating patients with learning disability and congenital anomalies in whom conventional cytogenetic tests have proven negative. However, given that this technology also identifies false positives at a similar rate to causal variants, caution in clinical practice should be advised.
Topics: Comparative Genomic Hybridization; Congenital Abnormalities; Humans; Intellectual Disability; Reproducibility of Results; Sensitivity and Specificity
PubMed: 19367186
DOI: 10.1097/GIM.0b013e318194ee8f -
Journal of Applied Research in... Mar 2022This systematic review aimed to explore the effects of sport and physical activity on behaviour and emotional problems, mental health and psychosocial well-being of... (Review)
Review
Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well-being in children and adolescents with intellectual disability: A systematic review.
BACKGROUND
This systematic review aimed to explore the effects of sport and physical activity on behaviour and emotional problems, mental health and psychosocial well-being of children and adolescents with intellectual disability.
METHOD
Five databases were searched systematically (ERIC, MEDLINE, PsycINFO, SportDISCUS and SCOPUS), up to 28 February 2021. Thirty-two studies met criteria for inclusion.
RESULTS
Studies in this review included case studies (n = 15), treatment trials (n = 14), cross sectional studies (n = 2) and a cohort study (n = 1). Evidence was positive, though high risk of bias in treatment trials (7 of 14 rated high) meant generalisability of results was limited.
CONCLUSIONS
The available evidence suggests a positive relationship between physical activity and improved behaviour and emotional problems, mental health and psychosocial well-being; however, more robust randomised controlled trials are required to confirm this.
Topics: Adolescent; Child; Cohort Studies; Cross-Sectional Studies; Exercise; Humans; Intellectual Disability; Mental Health
PubMed: 34796601
DOI: 10.1111/jar.12961 -
La Tunisie Medicale May 2009Mental retardation (MR) is a group of heterogeneous clinical conditions. There are more than 900 genetic disorders associated with MR and it affects around 3% of the... (Review)
Review
BACKGROUND
Mental retardation (MR) is a group of heterogeneous clinical conditions. There are more than 900 genetic disorders associated with MR and it affects around 3% of the general population. Many MR conditions described are syndromic, fragile X syndrome being the most common clinical entity among them. X linked mental retardation (XLMR) is subdivided in two categories: syndromic XLMR (MRXS) when MR is associated with clinical features and non-syndromic XLMR (MRX) when MR is isolated.
AIM
The aim of this systematic review of the literature was to join together the results of several studies related to X linked mental retardation and to present various genes implicated in this disease. In this review, focus has been given on genes implicated in mental retardation, the clinical data and on phenotype-genotype correlations.
METHODS
An exhaustive electronic and library research of the recent literature was carried out on the Web sites "Science Direct" and "Interscience Wiley". The key words used were "mental retardation", "X chromosome", "gene", "syndromic mental retardation", "non-syndromic mental retardation".
RESULTS
In this review a number of X linked genes, the clinical features associated with the gene abnormality, and the prevalence of the disease gene are discussed. We classified these genes by order of their first implication in MR. A table presented on the XLMR Update Web site who list the 82 known XLMR genes is available as XLMR Genes and corresponding proteins.
Topics: Humans; Mental Retardation, X-Linked
PubMed: 19927760
DOI: No ID Found -
Clinical Psychology Review Nov 2017Mental health problems affect people with intellectual disabilities (ID) at rates similar to or in excess of the non-ID population. People with severe ID are likely to... (Review)
Review
Mental health problems affect people with intellectual disabilities (ID) at rates similar to or in excess of the non-ID population. People with severe ID are likely to have persistent mental health problems. In this systematic review (PROSPERO 2015:CRD42015024469), we identify and evaluate the methodological quality of available measures of mental health problems or well-being in individuals with severe or profound ID. Electronic searches of ten databases identified relevant publications. Two reviewers independently reviewed titles and abstracts of retrieved records (n=41,232) and full-text articles (n=573). Data were extracted and the quality of included papers was appraised. Thirty-two papers reporting on 12 measures were included. Nine measures addressed a broad spectrum of mental health problems, and were largely observational. One physiological measure of well-being was included. The Aberrant Behavior Checklist, Diagnostic Assessment for the Severely Handicapped Scale-II and Mood, Interest and Pleasure Questionnaire are reliable measures in this population. However, the psychometric properties of six other measures were only considered within a single study - indicating a lack of research replication. Few mental health measures are available for people with severe or profound ID, particularly lacking are tools measuring well-being. Assessment methods that do not rely on proxy reports should be explored further.
Topics: Humans; Intellectual Disability; Mental Disorders; Personal Satisfaction; Psychiatric Status Rating Scales
PubMed: 28821007
DOI: 10.1016/j.cpr.2017.08.006 -
Journal of Applied Research in... Jan 2022People with intellectual disabilities have a high risk of developing mental ill-health. Treatment is often neglected and diagnosis is misattributed to a person's... (Review)
Review
BACKGROUND
People with intellectual disabilities have a high risk of developing mental ill-health. Treatment is often neglected and diagnosis is misattributed to a person's disability. Standard psychosocial interventions can improve a person's well-being. This review aimed to understand what interventions are being delivered, any benefits, and future recommendations.
METHODS
Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed, and the review registered with PROSPERO-CRD42020160254. Databases searched included: MEDLINE, Embase, and PsycINFO. A framework synthesis approach was used to present the findings.
RESULTS
There are limited psychosocial interventions offered for this population. When groups are delivered having a creative element, multiple activities over a short period of time, with breaks and group rules outcomes can be improved.
CONCLUSIONS
Adaptations and reasonable adjustments should be used specifically to a person's ability. A mixed-method design allows people to share their experiences alongside quantitative data that provides clinical information.
Topics: Disabled Persons; Humans; Intellectual Disability; Mental Health; Psychosocial Intervention
PubMed: 34337837
DOI: 10.1111/jar.12919 -
Journal of Intellectual Disability... May 2023Multiple measures of mental health problems and mental wellbeing for adults with intellectual disabilities are available, but investigations into their reliability and... (Review)
Review
BACKGROUND
Multiple measures of mental health problems and mental wellbeing for adults with intellectual disabilities are available, but investigations into their reliability and validity are still in the early stages. The aim of this systematic review was to provide an update to previous evaluations of measures of common mental health problems and wellbeing in adults with mild to moderate intellectual disabilities (ID).
METHODS
A systematic search was performed across three databases (MEDLINE, PsycINFO and SCOPUS). The literature search was limited to the years from 2009 to 2021 and to the original English versions. Ten papers evaluating nine measures were reviewed, and the psychometric properties of these measures were discussed using the Characteristics of Assessment Instructions for Psychiatric Disorders in Persons with Intellectual Developmental Disorders as a framework.
RESULTS
Four measures had at least one rating of 'good' across both dimensions of reliability and at least one dimension of validity and were deemed to have promising psychometric properties: the Clinical Outcomes in Routine Evaluation-Learning Disabilities, Impact of Events Scale-Intellectual Disabilities, Lancaster and Northgate Trauma Scales and Self-Assessment and Intervention (self-report section). Additionally, these measures were developed through consultations with mental health professionals and/or people with IDs and thus were deemed to have good content validity.
CONCLUSIONS
This review informs measurement choice for researchers and clinicians while highlighting a need for continued research efforts into the quality of measures available for people with IDs. The results were limited by incomplete psychometric evaluations of measures available. A paucity of psychometrically robust measures of mental wellbeing was observed.
Topics: Adult; Humans; Mental Health; Psychometrics; Intellectual Disability; Reproducibility of Results; Learning Disabilities
PubMed: 36808653
DOI: 10.1111/jir.13018