Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands.
Amarant Group, Healthcare Organization for People with Intellectual Disabilities, Tilburg, The Netherlands.
J Intellect Disabil Res. 2018 Aug;62(8):684-700. doi: 10.1111/jir.12502. Epub 2018 May 25.
Although high rates of depression symptoms are reported in adults with intellectual disabilities (IDs), there is a lack of knowledge about non-pharmacological treatment options for depression in this population. The first research question of this paper is: Which non-pharmacological interventions have been studied in adults with ID and depression? The second research question is: What were the results of these non-pharmacological interventions?
Systematic review of the literature with an electronic search in six databases has been completed with hand searches. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines have been followed. Selected studies met predefined inclusion criteria.
Literature search resulted in 4267 papers of which 15 met the inclusion criteria. Five different types of non-pharmacological interventions have been studied: cognitive behavioural therapy, behavioural therapy, exercise intervention, social problem-solving skills programme and bright light therapy.
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.
尽管智力障碍（ID）成年人中报告了高比例的抑郁症状，但对于该人群中抑郁的非药物治疗选择知之甚少。本文的第一个研究问题是：哪些非药物干预措施已在 ID 和抑郁的成年人中进行了研究？第二个研究问题是：这些非药物干预措施的结果如何？
对六家数据库进行了电子搜索，并辅以手工搜索，完成了文献的系统评价。研究遵循了系统评价和荟萃分析的首选报告项目指南。选定的研究符合预先设定的纳入标准。
文献搜索共产生了 4267 篇论文，其中有 15 篇符合纳入标准。研究了五种不同类型的非药物干预措施：认知行为疗法、行为疗法、运动干预、社交问题解决技能计划和亮光疗法。
仅有少数高质量的研究评估了 ID 和抑郁的成年人的非药物干预措施。其中一些研究，尤其是认知行为疗法的研究，显示出在降低抑郁症状方面的良好效果。需要进行高质量的随机对照试验，评估具有随访的非药物干预措施。
