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Komenda-Schned S, Landskron SJ, Moritz P, Brunevskaya N, Santambrogio J, Salvador-Carulla L, Lueger-Schuster B, Zeilinger EL. Good mental health in people with intellectual disabilities: a systematic review. Health Psychol Rev 2024:1-23. [PMID: 39260434 DOI: 10.1080/17437199.2024.2398021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 08/24/2024] [Indexed: 09/13/2024]
Abstract
While mental disorders have been broadly researched in people with intellectual disabilities (ID), comparatively less attention has been given to the conceptualisation of good mental health for this population. To capture existing concepts, definitions and measurement approaches of good mental health a systematic literature review was conducted following PRISMA guidelines. The search was carried out in eleven databases, using various synonyms of (i) intellectual disability, (ii) mental health, (iii) wellbeing, (iv) definition, and (v) assessment. A total of 2,046 datasets were identified, of which 37 met the inclusion criteria and were analysed using reflexive thematic analysis and content analysis. Results show four main themes: (1) environment, (2) absence of mental illness, (3) physical health, and (4) psychosocial functioning. The fourth was the most dominant theme and was further divided into five sub-themes: (1) emotionality, (2) interpersonal relations, (3) realise own potential, (4) personal resources, and (5) overall appraisal of life. Our findings reveal different conceptualisations of wellbeing, which is a vital part of good mental health, but highlight a notable research gap in the actual definition and conceptualisation of good mental health for people with ID.
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Affiliation(s)
- Sophie Komenda-Schned
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Vienna Doctoral School in Cognition, Behavior and Neuroscience, University of Vienna, Vienna, Austria
| | - Sarah Jasmin Landskron
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Paula Moritz
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Nadine Brunevskaya
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Jacopo Santambrogio
- Department of Medicine and Surgery, University Milano-Bicocca, Vedano al Lambro, Italy
| | - Luis Salvador-Carulla
- Faculty of Health, Health Research Institute, University of Canberra, Canberra, Australia
| | - Brigitte Lueger-Schuster
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Elisabeth Lucia Zeilinger
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Department of Clinical Research SBG, Academy for Ageing Research, Haus der Barmherzigkeit, Vienna, Austria
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Komenda S, Brunevskaya N, Moritz P, Landskron SJ, Zrnic Novakovic I, Oberleiter S, Wurzer J, Lueger-Schuster B, Salvador-Carulla L, Zeilinger EL. Concepts of good mental health and wellbeing in people with intellectual disability: Study protocol for a systematic review. Front Psychiatry 2023; 14:1148702. [PMID: 37091702 PMCID: PMC10116823 DOI: 10.3389/fpsyt.2023.1148702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Good mental health is an indispensable aspect of good general health and different definitions of good mental health have been developed for the general population. However, it is not clear how these definitions can be applied to people with intellectual disabilities (ID), as they may have difficulties in many facets encompassed in existing definitions. Yet, people with ID can be mentally healthy or mentally ill just as people without ID. Objective The aim of this systematic review is to summarize existing concepts, definitions, and measurement approaches of good mental health and wellbeing for people with ID. Methods A comprehensive, systematic literature review will be conducted in 11 databases, including ASSIA, CINAHL, Cochrane Library, ERIC, MedRxiv, OSF preprints, ProQuest Dissertations & Theses Global, PsycINFO, PubMed, Scopus, and Web of Science. By including preprints and theses servers in the search strategy, we will also consider grey and unpublished literature. The quality of included studies will be rated using standardized checklists. All steps of the literature search, data extraction, and quality rating will be performed independently by two trained researchers. Disagreements will be resolved through discussion between these researchers and, if required, by consulting a third team member. In a narrative synthesis, existing approaches to good mental health and wellbeing for people with ID will be systematically described and linked to current research in mental health for people with and without ID. Discussion The findings of this study will provide researchers and practitioners with an evidence-based overview of current approaches to good mental health and wellbeing of people with ID. We will explore and discuss the individual facets of the definitions, concepts, and measurement approaches and identify possible gaps which need to be addressed. This will strengthen future research on this topic and focus research activities on important and unresolved themes that need to be targeted to promote health equity for people with ID.
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Affiliation(s)
- Sophie Komenda
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Nadine Brunevskaya
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Paula Moritz
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sarah Jasmin Landskron
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Irina Zrnic Novakovic
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sandra Oberleiter
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Jana Wurzer
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Brigitte Lueger-Schuster
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Luis Salvador-Carulla
- Health Research Institute, Faculty of Health, University of, Canberra, ACT, Australia
| | - Elisabeth L. Zeilinger
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
- *Correspondence: Elisabeth L. Zeilinger,
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Hamadelseed O, Elkhidir IH, Skutella T. Psychosocial Risk Factors for Alzheimer's Disease in Patients with Down Syndrome and Their Association with Brain Changes: A Narrative Review. Neurol Ther 2022; 11:931-953. [PMID: 35596914 PMCID: PMC9338203 DOI: 10.1007/s40120-022-00361-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 12/02/2022] Open
Abstract
Several recent epidemiological studies attempted to identify risk factors for Alzheimer’s disease. Age, family history, genetic factors (APOE genotype, trisomy 21), physical activity, and a low level of schooling are significant risk factors. In this review, we summarize the known psychosocial risk factors for the development of Alzheimer’s disease in patients with Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. We completed a comprehensive review of the literature on PubMed, Google Scholar, and Web of Science about psychosocial risk factors for Alzheimer’s disease, for Alzheimer’s disease in Down syndrome, and Alzheimer’s disease in Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. Alzheimer’s disease causes early pathological changes in individuals with Down syndrome, especially in the hippocampus and corpus callosum. People with Down syndrome living with dementia showed reduced volumes of brain areas affected by Alzheimer’s disease as the hippocampus and corpus callosum in association with cognitive decline. These changes occur with increasing age, and the presence or absence of psychosocial risk factors impacts the degree of cognitive function. Correlating Alzheimer’s disease biomarkers in Down syndrome and cognitive function scores while considering the effect of psychosocial risk factors helps us identify the mechanisms leading to Alzheimer’s disease at an early age. Also, this approach enables us to create more sensitive and relevant clinical, memory, and reasoning assessments for people with Down syndrome.
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Affiliation(s)
- Osama Hamadelseed
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, University of Heidelberg, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany.
| | - Ibrahim H Elkhidir
- Faculty of Medicine, University of Khartoum, Alqasr St., Khartoum, Sudan
| | - Thomas Skutella
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, University of Heidelberg, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany
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Zeilinger EL, Zrnic Novakovic I, Komenda S, Franken F, Sobisch M, Mayer AM, Neumann LC, Loosli SV, Hoare S, Pietschnig J. Informant-based assessment instruments for dementia in people with intellectual disability: A systematic review and standardised evaluation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 121:104148. [PMID: 34954669 DOI: 10.1016/j.ridd.2021.104148] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/04/2021] [Accepted: 12/05/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Dementia in people with intellectual disability (ID) is frequent but hard to recognise. Evidence-based recommendations for suitable instruments are lacking. AIMS The present study set out to evaluate informant-based dementia assessment instruments and to provide evidence-based recommendations for instruments most suitable in clinical practice and research. METHOD AND PROCEDURES A systematic review was conducted across ten international electronic databases. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines, including a risk of bias assessment, was applied to extract information and to evaluate measurement properties and the quality of available evidence. OUTCOMES AND RESULTS In total, 42 studies evaluating 18 informant-based assessment instruments were analysed. For screening purposes, we recommend the Behavioral and Psychological Symptoms of Dementia in Down Syndrome Scale (BPSD-DS), the Cognitive Scale for Down Syndrome (CS-DS), and the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID). For a more thorough dementia assessment, we recommend the Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS). CONCLUSIONS AND IMPLICATIONS Our study informs clinicians and researchers about adequate, well-evaluated dementia assessment instruments for people with ID, and highlights the need for high quality studies, especially regarding content validity.
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Affiliation(s)
| | | | - Sophie Komenda
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Marc Sobisch
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Anna-Maria Mayer
- Institute of Psychology, University of Duisburg-Essen, Essen, Germany
| | - Lennart C Neumann
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Sandra V Loosli
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Hoare
- NELFT NHS Foundation Trust Goodmayes Hospital, Ilford, Essex, United Kingdom
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