• 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, and Jane Waite.
• Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany.
• BMJ Open. 2018 Jun 19; 8 (6): e021911.

ObjectiveMental 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.DesignA 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.ParticipantsStudy 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.InterventionsEligible intervention studies evaluated a psychological or pharmacological intervention using a control condition or pre-post design.OutcomesSymptom severity, frequency or other quantitative dimension (e.g., impact), as assessed with standardised measures of mental health problems.ResultsWe 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.ConclusionsMental 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 NumberCRD 42015024469.© 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.

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