Kok Lidwien, van der Waa Anne, Klip Helen, Staal Wouter
Department of Mild Intellectual Disabilities, Karakter Child and Adolescent Psychiatry, The Netherlands
Department of Mild Intellectual Disabilities, Karakter Child and Adolescent Psychiatry, The Netherlands.
Clin Child Psychol Psychiatry. 2016 Jan;21(1):156-71. doi: 10.1177/1359104514567579. Epub 2015 Jan 28.
Children with intellectual disability frequently have difficulties in adapting to their environment. The extent of the experienced problems does not only depend on cognitive functioning but is influenced by other factors, such as the presence of a psychiatric disorder or other brain disorders, or adverse environmental factors. Several epidemiological studies show that children with intellectual disabilities are at an increased risk to develop psychiatric disorders. This is also true for youth with a mild intellectual disability and even those with borderline intellectual functioning (mild to borderline intellectual disability (MBID)). Psychiatric disorders are often overlooked because behavioral problems are rather attributed to the intellectual disability. Consequently, effective psychiatric interventions, which are needed to improve the level of functioning, are not applied. This review aimed to systematically evaluate the currently available, qualitatively sound research concerning the effectiveness of psychosocial interventions, specifically directed at psychiatric disorders in children with MBID. Assessed for eligibility were 1409 unique reports, and the review ultimately included only 12 reports. Review of the results and meta-analyses showed that the majority of studies suffer from multiple limitations and that methodological variations between studies are extensive. This possibly reflects the high variance of factors that may be involved in MBID. It will be important in future research to address multi-causality.
智力残疾儿童在适应环境方面常常存在困难。所经历问题的程度不仅取决于认知功能，还受到其他因素的影响，如精神障碍或其他脑部疾病的存在，或不利的环境因素。多项流行病学研究表明，智力残疾儿童患精神障碍的风险增加。对于轻度智力残疾的青少年甚至那些边缘智力功能（轻度至边缘智力残疾（MBID））的青少年来说也是如此。精神障碍常常被忽视，因为行为问题往往被归因于智力残疾。因此，提高功能水平所需的有效精神科干预措施并未得到应用。本综述旨在系统评价目前关于心理社会干预有效性的高质量研究，这些干预特别针对MBID儿童的精神障碍。评估了1409份独立报告的资格，而该综述最终仅纳入了12份报告。对结果的回顾和荟萃分析表明，大多数研究存在多种局限性，且研究之间的方法差异很大。这可能反映了MBID中可能涉及的因素的高度变异性。在未来的研究中解决多因果关系将很重要。
