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

Abstract

There are only a few studies of good quality evaluating non-pharmacological interventions for adults with ID and depression. Some of these studies, especially studies on cognitive behavioural therapy, show good results in decreasing depressive symptoms. High-quality randomised controlled trials evaluating non-pharmacological interventions with follow-up are needed.

The effect of bright light therapy on depressive symptoms in adults with intellectual disabilities: Results of a multicentre randomized controlled trial

“…Positive results were found in these first explorations of BLT to decrease depressive symptoms in adults with intellectual disabilities, but these must be interpreted with caution because of the lack of a randomization procedure and control groups. Therefore, the strengths of the current study, for example the block randomization and blinding procedures, and the strictly protocolled intervention, make this study adding important information to the existing literature (Hamers, Festen, et al, 2018). As most studies, our study has a couple of limitations which must be mentioned.…”

“…Compared to the general population, even higher numbers of depression and depressive symptoms are found in the population of adults with intellectual disabilities (Cooper, Smiley, Morrison, Williamson, & Allan, 2007; Hermans, Beekman, & Evenhuis, 2013). Despite the large number of adults with intellectual disabilities and depressive symptoms, treatment options, especially for those with severe intellectual disabilities, are scarce (Hamers, Festen, & Hermans, 2018). Some adults with mild or moderate intellectual disabilities and without major verbal limitations may benefit from psychological interventions, for example cognitive behavioural therapy (CBT) (Vereenooghe & Langdon, 2013), but a large part of adults with intellectual disabilities and depressive symptoms get pharmacological treatment or no treatment at all.…”

Interventions for sleep difficulties in adults with an intellectual disability: a systematic review

“…; Majeske et al . ; Hamers, Festen & Hermans ). This indicates that the improvement of sleep in adults with an ID may involve a careful consideration of co‐occurring morbidities and what works for those morbidities.…”

“…As having an ID is frequently comorbid with other physical, behavioural and mental health conditions, sleep disruption is often an indirect consequence of co-morbidity. For instance, results from studies focusing on fitness, depression and bipolar disorder indicate positive effects on sleep following interventions (Altabet et al 2001;Wilhite et al 2012;Majeske et al 2013;Hamers, Festen & Hermans 2018). This indicates that the improvement of sleep in adults with an ID may involve a careful consideration of co-occurring morbidities and what works for those morbidities.…”

An under-represented and underserved population in trials: methodological, structural, and systemic barriers to the inclusion of adults lacking capacity to consent

“…Trials involving adults lacking capacity can be methodologically challenging; challenges include the difficulties of developing (or adapting) complex interventions [54], evaluating interventions [55] (including developing a common protocol for use in different jurisdictions [39]), the lack of appropriate outcome measures, and the challenges of ensuring intervention fidelity [17]. However, the frequent exclusion of this group from research has led to Age UK describing them as living in a 'knowledge shadow' [56].…”