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Psychological therapies for people with intellectual disabilities : an updated systematic review and meta-analysis
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Tapp, Katherine, Vereenooghe, Leen, Hewitt, Olivia, Scripps, Emma, Gray, Kylie M. and Langdon, Peter E. (2023) Psychological therapies for people with intellectual disabilities : an updated systematic review and meta-analysis. Comprehensive Psychiatry, 122 . 152372. doi:10.1016/j.comppsych.2023.152372 ISSN 0010-440X.
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Official URL: http://dx.doi.org/10.1016/j.comppsych.2023.152372
Abstract
Objective
The aim of this systematic review and meta-analysis (PROSPERO 2020 CRD42020169323) was to evaluate the efficacy of psychological therapy for people with intellectual disabilities.
Method
A comprehensive literature search yielded 22,444 studies which were screened for eligibility. Studies were eligible for inclusion if a psychological therapy was delivered to people with intellectual disabilities compared to a group who did not receive the therapy. Thirty-three controlled trials were eligible for inclusion in the review, with 19 included within a DerSimonian-Laird random effects meta-analysis. Subgroup analysis was completed by clinical presentation, and by comparing randomised trials to non-randomised trials, and group-based to individually delivered psychotherapy.
Results
Following the removal of outliers, psychological therapy for a range of mental health problems was associated with a small and significant effect size, g = 0.43, 95% CI [0.20, 0.67], N = 698. There was evidence of heterogeneity and bias due to studies with small sample sizes and a lack of randomisation. Non-randomised studies were associated with a large effect size, g = 0.90, 95% CI [0.47, 1.32], N = 174, while randomised studies were associated with a small effect size, g = 0.36, 95% CI [0.17, 0.55], N = 438, excluding outliers. Individually delivered psychological therapy was associated with a small and non-significant effect size, g = 0.32, 95% CI [−0.01, 0.65], N = 146, while group-based interventions were associated with a small and significant effect size, g = 0.37, 95% CI [0.05, 0.68], N = 361, again, excluding outliers. Psychological therapy for anger was associated with a moderate effect size, g = 0.60, 95% CI [0.26, 0.93], N = 324, while treatment for depression and anxiety was associated with a small and non-significant effect size, g = 0.38, 95% CI [−0.10, 0.85], N = 216, after outliers were removed.
Conclusions
Studies are fraught with methodological weaknesses limiting the ability to make firm conclusions about the effectiveness of psychological therapy for people with intellectual disabilities. Improved reporting standards, appropriately powered and well-designed trials, and greater consideration of the nature and degree of adaptations to therapy are needed to minimise bias and increase the certainty of conclusions.
Item Type: | Journal Article | |||||||||
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Subjects: | H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RC Internal medicine R Medicine > RJ Pediatrics |
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Divisions: | Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Learning disabilities , Learning disabilities -- Physiological aspect, Learning disabilities -- Treatment , Developmentally disabled , Developmental disabilities -- Treatment, Developmental disabilities -- Diagnosis | |||||||||
Journal or Publication Title: | Comprehensive Psychiatry | |||||||||
Publisher: | Elsevier | |||||||||
ISSN: | 0010-440X | |||||||||
Official Date: | April 2023 | |||||||||
Dates: |
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Volume: | 122 | |||||||||
Article Number: | 152372 | |||||||||
DOI: | 10.1016/j.comppsych.2023.152372 | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||
Date of first compliant deposit: | 1 February 2023 | |||||||||
Date of first compliant Open Access: | 1 February 2023 | |||||||||
RIOXX Funder/Project Grant: |
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