Storm M M C, van Eldik W M, Nooteboom L A, Vermeiren R R J M
LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands.
Parnassia Group, Youz, De Banjaard, The Hague, The Netherlands.
Eur Child Adolesc Psychiatry. 2025 Jul 1. doi: 10.1007/s00787-025-02794-7.
Individuals with intellectual disability (ID) face a higher risk for developing mental health problems. Recent research emphasizes the relevance of social determinants of mental health (SDOMH) in relation to this risk. This review aims to synthesize evidence on the associations between SDOMH and mental health in youth with ID, focusing on risk and protective factors across demographic, economic, social, and neighborhood domains. A systematic search of multiple databases identified 51 relevant studies, including 36 cross-sectional and 15 longitudinal studies. Using a framework-led approach, the strongest evidence emerged from the social/cultural domain (n = 46), followed by economic (n = 17), demographic (n = 8), and neighborhood (n = 1). A key finding is the substantial variability and mixed results across studies, highlighting complex, context-dependent associations. Nonetheless, some patterns emerged within the social/cultural domain. Based on both cross-sectional and longitudinal evidence, the most consistent links were found between social and cultural stressors and mental health vulnerabilities. Specifically, in families where children with ID displayed more behavioral problems, 1) parents experienced high distress or internalizing problems; 2) parenting behaviors were more negative; and 3) children faced stressful life events. The review also reveals notable research gaps, including limited attention to broader environmental and neighborhood factors, few longitudinal and multivariate studies, and minimal focus on protective factors. Future research should adopt a systematic approach, prioritize underexplored environmental and protective factors, apply longitudinal and multivariate designs to examine causal pathways, incorporate qualitative methods, and standardize measures to enable consistent analysis across studies.
智力残疾(ID)个体患心理健康问题的风险更高。最近的研究强调了心理健康的社会决定因素(SDOMH)与这种风险的相关性。本综述旨在综合关于SDOMH与ID青年心理健康之间关联的证据,重点关注人口、经济、社会和邻里领域的风险和保护因素。对多个数据库进行系统检索后,确定了51项相关研究,包括36项横断面研究和15项纵向研究。采用框架主导的方法,最强的证据来自社会/文化领域(n = 46),其次是经济领域(n = 17)、人口领域(n = 8)和邻里领域(n = 1)。一个关键发现是各研究之间存在很大的变异性和混合结果,突出了复杂的、依赖于背景的关联。尽管如此,在社会/文化领域内还是出现了一些模式。基于横断面和纵向证据,在社会和文化压力源与心理健康脆弱性之间发现了最一致的联系。具体而言,在患有ID的儿童表现出更多行为问题的家庭中,1)父母经历了高度痛苦或内化问题;2)育儿行为更消极;3)儿童面临压力性生活事件。该综述还揭示了显著的研究空白,包括对更广泛的环境和邻里因素关注有限、纵向和多变量研究较少以及对保护因素关注极少。未来的研究应采用系统方法,优先考虑未充分探索的环境和保护因素,应用纵向和多变量设计来检验因果途径,纳入定性方法,并标准化测量方法,以便能够在各项研究之间进行一致的分析。