6 research outputs found
Shine a Light on Depressive Symptoms in Adults with Intellectual Disabilities: Diagnostics and Non-pharmacological Treatment
The effect of bright light therapy on depressive symptoms in adults with intellectual disabilities: Results of a multicentre randomized controlled trial
Background: Although a large number of adults with intellectual disabilities have depressive symptoms, non-pharmacological treatments are scarce. The present authors
investigated whether bright light therapy (BLT) is effective in decreasing depressive
symptoms compared to care as usual.
Methods: This multicentre randomized controlled trial consisted of three study
groups (10,000 lux BLT, dim light BLT and a no-BLT group). Participants received
BLT for 30 min in the morning (14 consecutive days), additional to their regular care.
Primary outcome was as follows: depressive symptoms measured with the ADAMS
Depressive Mood subscale 1 week after the end of BLT (same time period in the noBLT group).
Results: Forty-one participants were included in our trial. In both BLT groups, a significant decrease in depressive symptoms was seen. No significant differences were
found between 10,000 lux BLT and no-BLT (p = .199) and no significant differences
between dim light BLT and no-BLT (p = .451). A minimum amount of side effects and
no adverse events were reported.
Conclusions: In both BLT interventions, a decrease in depressive symptoms was seen.
With 10,000 lux BLT, depressive symptoms decreased even below the clinical cut-off
point, which makes BLT a promising intervention for clinical practice
Reliability and validity of the Dutch Anxiety, Depression And Mood Scale in adults aged <50Â years with intellectual disabilities
Background: Reliable and valid screening instruments for depression and anxiety are needed for adults with intellectual disabilities. Methods: Internal consistency (n = 198), inter-rater reliability (n = 41), test–retest reliability (n = 37) and criterion validity (n = 43) were studied in adults aged between 18 and 49 years. Internal consistency was also studied in a sample with epilepsy (n = 98). Results: Internal consistencies of the Dutch ADAMS total scale and subscales were satisfactory to good (α = 0.76–0.92), as well as in the subgroup with epilepsy (α = 0.74–0.88). Inter-rater reliability and test–retest reliability were fair to excellent for the total scale (ICC’s: 0.57–0.84) and subscales (ICC’s: 0.43–0.86). The criterion validity of the Dutch ADAMS Depressive Mood subscale was good with a sensitivity of 88% (95% CI: 53%–98%) and a specificity of 80% (95% CI: 64%–90%). Conclusions: Our study shows that the Dutch ADAMS is a reliable and valid instrument for adults aged between 18 and 49 years with intellectual disabilities (and comorbid epilepsy)
Reliability and validity of the Dutch Anxiety, Depression And Mood Scale in adults aged <50Â years with intellectual disabilities
Background: Reliable and valid screening instruments for depression and anxiety are needed for adults with intellectual disabilities. Methods: Internal consistency (n = 198), inter-rater reliability (n = 41), test–retest reliability (n = 37) and criterion validity (n = 43) were studied in adults aged between 18 and 49 years. Internal consistency was also studied in a sample with epilepsy (n = 98). Results: Internal consistencies of the Dutch ADAMS total scale and subscales were satisfactory to good (α = 0.76–0.92), as well as in the subgroup with epilepsy (α = 0.74–0.88). Inter-rater reliability and test–retest reliability were fair to excellent for the total scale (ICC’s: 0.57–0.84) and subscales (ICC’s: 0.43–0.86). The criterion validity of the Dutch ADAMS Depressive Mood subscale was good with a sensitivity of 88% (95% CI: 53%–98%) and a specificity of 80% (95% CI: 64%–90%). Conclusions: Our study shows that the Dutch ADAMS is a reliable and valid instrument for adults aged between 18 and 49 years with intellectual disabilities (and comorbid epilepsy)
Antipsychotics withdrawal in adults with intellectual disability and challenging behaviour
Background: In people with intellectual disability (ID) and challenging behaviour, antipsychotics (AP) are often used off-label and for a long period. Despite a lack of evidence for efficacy for challenging behaviour and concerns about common and clinically relevant side effects, complete withdrawal often fails. We postulate three possible hypotheses for withdrawal failure: 1. Influence of subjective interpretation of behavioural symptoms by caregivers and family; 2. Beneficial effects from AP treatment on undiagnosed psychiatric illness, through improvement in sleep or a direct effect on behaviour; and 3. Misinterpretation of withdrawal symptoms as a recurrence of challenging behaviour. Methods: To investigate our hypotheses, we have designed a multicentre double-blind, placebo-controlled randomised trial in which AP (pipamperone or risperidone) are withdrawn. In the withdrawal group, the AP dose is reduced by 25% every 4 weeks and in the control group the dose remains unalt