Background Cognitive skills thought to be necessary to undertake cognitive-behavioural therapy (CBT) include the ability to recognize emotions, link events and emotions, and recognize cognitive mediation. These skills have been assessed in people with intellectual disabilities, but not in those who also have psychosis. Materials and methods Tasks assessing receptive language ability and cognitive skills including the ability to differentiate between behaviours, thoughts and feelings were administered to 50 participants who had intellectual disabilities and psychosis. Results The majority of participants were able to link events and emotions and differentiate behaviours and feelings. Participants found any task involving cognitions significantly more difficult. Performance on recognizing emotions, linking events and emotions and on some of the cognitive mediation and differentiation tasks was associated with receptive language ability. Conclusions People with intellectual disabilities and psychosis have some of the skills thought to be required to undertake cognitive behaviour therapy. Recognizing cognitions and cognitive mediation is particularly challenging. The differentiation task introduced in this study may usefully supplement existing assessments.

Depression is the most common psychiatric condition found in older people. It is associated with increased mortality and adversely affects quality of life. Although the majority of depressive episodes are seen and treated in primary care, studies suggest in primary care there is under-detection and inadequate management of depression in older people. In line with national policy in the UK this paper argues that training needs to be multidisciplinary and multiagency, and meet the requirements of local needs. It outlines a course that meets the expectation that specialist mental health workers such as mental health nurses should provide training and advice for those providing care and treatment in primary care. The paper reports upon the design and evaluation of a pilot multidisciplinary training course for health professionals and voluntary sector workers in the detection and management of depression in the older person. The course consisted of three 1-day workshops and four consecutive courses were offered, with a total of 40 health professionals and voluntary sector workers completing the training. The training was evaluated using a questionnaire examining knowledge and confidence and by a scenario using an older person whom was potentially depressed. Results found a significant difference between pre- and post-test for knowledge of depression in the older person and confidence in both detecting and managing depression. Results of the scenario revealed that there was a significant change from pre- to post-test training in the type of questions participants would ask the older person to detect and assess depression. There was also a significant increase in the ability to identify types of interventions and local services available, which would help an older person with depression. The implications, limitations and future directions for research are discussed.

Background There is paucity in availability of valid and reliable measures of psychopathology that can be routinely applied with an intellectual disability (ID) population in clinical practice. The psychometric properties of the Clinical Outcome Routine Evaluation-Learning Disabilities 30-Item version (CORE-LD30) are examined. Method The CORE-LD30 was administered to 271 sequential referrals to three National Health Service (NHS) ID services providing psychological support. A principal components analysis with oblique rotation was conducted with examination of convergent validity for extracted domains. Results Three rotated factors were extracted with good levels of internal consistency reported for the overall measure (α = 0.92) and each of the domains, conceptually labelled Problems/Symptoms (α = 0.90), Risk to Self (α = 0.76) and Risk to Others (α = 0.71). Convergent validity is reported for two domains [Problems/Symptoms with the Glasgow Depression Scale for people with a learning disability (LD) and Risk to Others with the Health of the Nation Outcome Scale-LD], and support for the CORE-LD30 as a 'core' measure indicated. Conclusions The CORE-LD30 is recommended as a useful broad ranging measure of psychopathology for use with an ID population. Domains may prove to be useful for research and clinical purposes. Further research is recommended to examine the ability to monitor clinical change associated with specific levels of presentation and different clinical presentations/cohorts.

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