Characteristics of pharmacological and psychological interventions studies
| First author (year) | Study design* | Participants | Intervention | Outcomes | Follow-up |
| Psychopharmacological interventions | |||||
| Aman32 (1986) | Double-blind placebo controlled crossover trial Within-group randomisation I1: imipramine I2: placebo 1-week washout period between interventions | Adults with depressive and affective symptoms n=5 (2M/3F) Age range: 18–23 years intellectual disabilities severity: Slosson IQ† range 10–14 | Imipramine (Dumex) or placebo Duration: 4 weeks Dose: 3 mg/kg/day Setting: residential ward | Imipramine caused symptom deterioration for ABC scores related to irritability, lethargy and hyperactivity. No intervention effects were observed for: stereotypy and inappropriate speech. Statistical data only provided for analyses including a second intervention group, non-eligible for review. | No follow-up |
| Rosenquist33 (1997) | Single-case experimental reversal design (ABABA) A, baseline B, haloperidol Single-blind, masked assessment | Adult with Gilles de la Tourette syndrome n=1, female Age=35 years Severe intellectual disabilities | Haloperidol Duration: 22 weeks, A: 2 weeks baseline B: 8 weeks intervention A: 2 weeks baseline B: 8 weeks intervention A: 2 weeks baseline Dose: -Week 1: 1 mg/day -Week 2: 2 mg/day -Weeks 3–4: 5 mg/day -Weeks 5–6: 10 mg/day -Weeks 7–8: washout Setting: community group home | Weekly observations using Behavioral Observation and Tic Checklist‡ of three videotaped conditions: (1) table setting task, (2) mealtime and (3) waiting. Pre-post % time (SD) engaged in tic behaviour at baseline and week 1 (dose 1 mg/day): Mealtime: SM-tic: 34.8 (20); 11.0 (12) CM-tic: 13.6 (10); 5.3 (8) SV-tic: 35.4 (28); 2.0 (4) CV-tic: 1.3 (3); 0.0 (0) Waiting: SM-tic: 46.8 (31); 20.8 (26) CM-tic: 41.2 (19); 25.3 (21) SV-tic: 65.3 (29); 69.6 (25) CV-tic: 42.5 (18); 23.0 (18) | Week 6 of increased dosage % time (SD) engaged in tic behaviour at week 6 (dose 10 mg/day): Mealtime: SM-tic: 6.3 (6) CM-tic: 3.0 (3) SV-tic: 1.0 (3) CV-tic: 1.0 (2) Waiting: SM-tic: 24.7 (20) CM-tic: 41.5 (18) SV-tic: 48.4 (26) CV-tic: 34.8 (20) Dose-specific improvements (10 mg/day), reversible |
| White35 (1985) | Double-blind placebo controlled crossover trial I1: pimozide I2: placebo Randomisation within participants 1-week washout period between interventions | Inpatients with serious behaviour disturbances, including hyperactivity n=8, 7M/1F Mean age 15.7 years (SD=3.42) intellectual disabilities severity: moderate to profound; mean IQ=20.4 (SD=12.11) | Pimozide or placebo Baseline: 4 weeks Intervention: 4 weeks+4 weeks Dose: I1: 6 mg/day Setting: no info | ANCOVA for drug effects and baseline as covariate on ABC subscales Pimozide has an effect: Irritability: F=11.78 Hyperactivity: F=7.69 No significant effects for: Lethargy: F=0.84 Stereotypy: F=3.48 Inappropriate speech: F=1.31 | No follow-up |
| Psychological interventions | |||||
| Lindauer34 (1999) | Single-case experimental reversal design (ABAB) A, baseline: empty room and quiet hands procedure B, enriched environment and quiet hands | Mood disorder, major depression n=1, female Age=23 years Severe intellectual disabilities | Enriched environment: 12 items selected for inclusion by paired-choice assessment Duration: 57 sessions A: 11 sessions B: 5 sessions A: 29 sessions B: 12 sessions Dose: 10 min sessions Setting: laboratory, padded room | Percentage of 10 s intervals of signs of negative and positive affects Pre: relatively high levels of negative affect (M=27.4%) and low levels of positive affect (M=2.3%) Post: negative affect decreased (M=0.1%) and positive affect increased, especially during B2 (M=11.5% across phases). | No follow-up |
| Zarkowska36 (1989) | Two single-case experimental reversal designs (ABA) I1: relaxation A, baseline: school activity, tics ignored B, relaxation A, baseline: return to school activity, tics ignored I2: interruption A, baseline: school activity, tics ignored B, interruption A, baseline: return to school activity, tics ignored | Gilles de la Tourette syndrome n=1, female Age=13 years Severe intellectual disabilities (Griffiths Mental Development Scale score ranged from 17 to 42 months) | I1: verbal instructions for relaxation exercises and praise when calm Duration: 10 min I2: verbal interruption following the occurrence of a verbal tic Duration: 10 min | I1 reduced tic frequency during relaxation but returned to baseline after intervention I2 increased vocal tic frequency. After I1 and I2: no generalised reduction in tic frequency | No follow-up |
I1, intervention 1; I2, intervention 2; G1, group 1; G2, group 2; gender ratio expressed as male/female; outcomes reported for primary outcome measure only, unless where mental health or mental well-being outcome measure was recorded as secondary outcome measures.
↵*AB designs with A: baseline and B: treatment.
↵†Slosson IQ scores correlate highly with Stanford Binet Intelligence Test scores and correlate with the Cattell Infant Intelligence Scale when used with children under the age of 2 41.
‡SM-tic, simple motor tic; CM-tic, complex motor tic; SV-tic, simple vocal tic; CV-tic, complex vocal tic.
ABC, Aberrant Behavior Checklist; ANCOVA, analysis of covariance.