Non-specialist psychosocial intervention for children and adolescents with intellectual disability or lower-functioning autism spectrum disorders: a systematic review

Abstract Background: The development of effective treatments for use by non-specialists is listed among the top research priorities for improving the lives of people with mental illness worldwide. The purpose of this review is to appraise which interventions for children with intellectual disabilities or lower-functioning autism spectrum disorders delivered by nonspecialist care providers in community settings produce benefits when compared to either a no-treatment control group or treatment-as-usual comparator

Interventions for common perinatal mental disorders in women in low- and middle-income countries: a systematic review and meta-analysis

Objective: To assess the effectiveness of interventions to improve the mental health of women in the perinatal period and to evaluate any effect on the health, growth and development of their offspring, in low- and middle-income (LAMI) countries. Methods: Seven electronic bibliographic databases were systematically searched for papers published up to May 2012 describing controlled trials of interventions designed to improve mental health outcomes in women who were pregnant or had recently given birth. The main outcomes of interest were rates of common perinatal mental disorders (CPMDs), primarily postpartum depression or anxiety; measures of the quality of the mother-infant relationship; and measures of infant or child health, growth and cognitive development. Meta-analysis was conducted to obtain a summary measure of the clinical effectiveness of the interventions. Findings: Thirteen trials representing 20 092 participants were identified. In all studies, supervised, non-specialist health and community workers delivered the interventions, which proved more beneficial than routine care for both mothers and children. The pooled effect size for maternal depression was -0.38 (95% confidence interval: -0.56 to -0.21; I (2) = 79.9%). Where assessed, benefits to the child included improved mother-infant interaction, better cognitive development and growth, reduced diarrhoeal episodes and increased immunization rates. Conclusion: In LAMI countries, the burden of CPMDs can be reduced through mental health interventions delivered by supervised non-specialists. Such interventions benefit both women and their children, but further studies are needed to understand how they can be scaled up in the highly diverse settings that exist in LAMI countries

If You Could Only Choose Five Psychotropic Medicines: Updating the Interagency Emergency Health Kit

Mark van Ommeren and colleagues describe how they chose five psychotropic medicines to add to the Interagency Emergency Health Kit, which is a box with medicines and medical supplies designed to help people in major humanitarian emergencies

Responsible Governance for Mental Health Research in Low Resource Countries

Blurb: Taghi Yasamy and colleagues identify challenges facing good research governance in low- and middle-income countries and provide suggestions for a way forward

Responsible Governance for Mental Health Research in Low Resource Countries

Blurb: Taghi Yasamy and colleagues identify challenges facing good research governance in low- and middle-income countries and provide suggestions for a way forward

Challenges in Developing Evidence-Based Recommendations Using the GRADE Approach: The Case of Mental, Neurological, and Substance Use Disorders

Corrado Barbui and colleagues describe their use and adaptation of the GRADE approach in developing the guidelines for the WHO mental health Gap Action Programme (mhGAP)

The Role of Health Systems Factors in Facilitating Access to Psychotropic Medicines: A Cross-Sectional Analysis of the WHO-AIMS in 63 Low- and Middle-Income Countries

In a cross-sectional analysis of WHO-AIMS data, Ryan McBain and colleagues investigate the associations between health system components and access to psychotropic drugs in 63 low and middle income countries

Non-Specialist Psychosocial Interventions for Children and Adolescents with Intellectual Disability or Lower-Functioning Autism Spectrum Disorders: A Systematic Review

Background: The development of effective treatments for use by non-specialists is listed among the top research prioritiesfor improving the lives of people with mental illness worldwide. The purpose of this review is to appraise whichinterventions for children with intellectual disabilities or lower-functioning autism spectrum disorders delivered by nonspecialistcare providers in community settings produce benefits when compared to either a no-treatment control group ortreatment-as-usual comparator.Methods and Findings: We systematically searched electronic databases through 24 June 2013 to locate prospectivecontrolled studies of psychosocial interventions delivered by non-specialist providers to children with intellectual disabilitiesor lower-functioning autism spectrum disorders. We screened 234 full papers, of which 34 articles describing 29 studiesinvolving 1,305 participants were included. A majority of the studies included children exclusively with a diagnosis of lowerfunctioningautism spectrum disorders (15 of 29, 52%). Fifteen of twenty-nine studies (52%) were randomized controlledtrials and just under half of all effect sizes (29 of 59, 49%) were greater than 0.50, of which 18 (62%) were statisticallysignificant. For behavior analytic interventions, the best outcomes were shown for development and daily skills; cognitiverehabilitation, training, and support interventions were found to be most effective for improving developmental outcomes,and parent training interventions to be most effective for improving developmental, behavioral, and family outcomes. Wealso conducted additional subgroup analyses using harvest plots. Limitations include the studies\u2019 potential for performancebias and that few were conducted in lower- and middle-income countries.Conclusions: The findings of this review support the delivery of psychosocial interventions by non-specialist providers tochildren who have intellectual disabilities or lower-functioning autism spectrum disorders. Given the scarcity of specialists inmany low-resource settings, including many lower- and middle-income countries, these findings may provide guidance forscale-up efforts for improving outcomes for children with developmental disorders or lower-functioning autism spectrumdisorders

Responsible governance for mental health research in low resource countries

aghi Yasamy and colleagues identify challenges facing good research governance in low- and middle-income countries and provide suggestions for a way forward

Parent skills training for parents of children or adults with developmental disorders: systematic review and meta-analysis protocol

INTRODUCTION: Developmental disorders, including intellectual disability and autism spectrum disorders, may limit an individual's capacity to conduct daily activities. The emotional and economic burden on families caring for an individual with a developmental disorder is substantial, and quality of life may be limited by a lack of services. Therefore, finding effective treatments to help this population should be a priority. Recent work has shown parent skills training interventions improve developmental, behavioural and family outcomes. The purpose of this review protocol is to extend previous findings by systematically analysing randomised controlled trials of parent skills training programmes for parents of children with developmental disorders including intellectual disabilities and autism spectrum disorders and use meta-analytic techniques to identify programme components reliably associated with successful outcomes of parent skills training programmes. METHODS AND ANALYSIS: We will include all studies conducted using randomised control trials designs that compare a group of parents receiving a parent skills training programme to a group of parents in a no-treatment control, waitlist control or treatment as usual comparison group. To locate studies, we will conduct an extensive electronic database search and then use snowball methods, with no limits to publication year or language. We will present a narrative synthesis including visual displays of study effects on child and parental outcomes and conduct a quantitative synthesis of the effects of parent skills training programmes using meta-analytic techniques. ETHICS AND DISSEMINATION: No ethical issues are foreseen and ethical approval is not required given this is a protocol for a systematic review. The findings of this study will be disseminated through peer-reviewed publications and international conference presentations. Updates of the review will be conducted, as necessary, to inform and guide practice. TRIAL REGISTRATION NUMBER: PROSPERO (CRD42014006993)