1. (1) To appreciate the unique mental health challenges of university students with ASC.

2. (2) To identify psychological interventions that are suitable for individuals with ASC.

3. (3) To consider the value in employing more than one evidence-based cognitive model of anxiety when clients present with co-morbid mental health issues.

4. (4) To question the utility of using standardised outcome measures compared with idiographic measures in therapy.

1. (1) To understand the strengths and limitations of existing transdiagnostic CBT formulation models.

2. (2) To learn about a novel, transdiagnostic and behaviourally focused formulation for use in clinical practice.

3. (3) To understand how to use the tool in clinical practice and future research.

Depression is an alarming burden in India causing substantial disability and cost to society. Recognizing depression is difficult because patients present predominantly with somatic symptoms or because attention is primarily focused on the co-morbid physical disorder. The cases of depression presenting in primary-care settings are either not identified or treated with inappropriate drugs or inadequate doses of anti-depressants.

To analyze current level of intervention done by non-psychiatrists to detect and manage depression in patients with chronic medical illnesses.

A panel of nine specialists (Cardiologists, Neurologists, Endocrinologists and Psychiatrists) discussed current Indian scenario of management of co-morbid depression by non-psychiatrists.

The panel agreed that

• Prevalence of co-morbid depression in India is not well-documented except for few regional studies.

• It is frequently witnessed but is hardly recognized or managed as a concurrent disease.

• There is a need to differentiate between depressive 'feeling” and 'disease”.

• The clinicians should increase duration of history-taking to include questions like, 'Do you feel sad/low? Are you disinterested?” in suspected cases.

• There is a need for developing Indian consensus to identify co-morbid depression, to decide when to start an antidepressant drug, in what dosage and duration with special focus on the when to refer to a psychiatrist.

Concrete steps are required towards large-scale data generation and development of Indian consensus on the management of co-morbid depression in patients with chronic medical illnesses for the non-psychiatrists to improvise patient health outcome.

To evaluate the clinical benefits and associated cost effectiveness of an intensive personalised support (IPS) approach for clients suffering from psychosis and co-morbid mild intellectual disability (ID).

Four individuals with a psychotic disorder and co-morbid mild ID participated in an 18-month IPS rehabilitative intervention. Biopsychosocial measures were used to evaluate clinical effectiveness. A cost analysis was undertaken to examine the cost effectiveness of the intervention.

Reductions in psychopathology including anxiety symptoms were noted in all individuals. In addition, increased functioning and quality of life were demonstrated in all cases. Overall cost reductions were noted in inpatient care, accommodation and legal/emergency expenses.

The IPS approach was clinically effective particularly in addressing individual’s psychosocial needs, psychological functioning, daily living skills and overall quality of life. Costs had decreased for three of the four individuals, ranging from a 17% to 46% savings. The findings highlight that the intervention was cost effective in most cases at this early stage. However, further research is necessary in order to ascertain if cost savings occur over time.

Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults.

A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale.

Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder.

Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.

To describe the characteristics and progress of the first 50 patients with severe and enduring mental illness who accessed inpatient rehabilitation services in Dublin North East Mental Health Service between 2001 and 2006.

Retrospective collection of data on the first 50 inpatients from case notes and staff interviews. Data included demographics, psychiatric history, results of rehabilitation interventions and assessment tools. The results were compiled and analysed using descriptive statistics.

Fifty patients were identified. The majority were male (68%) with a diagnosis of paranoid schizophrenia (60%). The levels of co-morbid alcohol and drug misuse were 40% and 30% respectively. Histories of verbal/physical aggression were found in 92% and impulsive behaviour in 70%. The majority of patients had a past history of being detained under the Mental Treatment Act (1945). High levels of co-morbid physical health problems were identified. New long-stay (NLS) patients showed a trend towards requiring the shortest admissions prior to being ready for discharge to lower levels of support.

One third of patients moved on to reside at lower support levels and accessed vocational training programmes following active inpatient rehabilitation interventions. However, there remained a cohort of patients who required prolonged inpatient admissions due to their high levels of disability. This study further highlights the need to ensure that a range of rehabilitation services from inpatient to supported community placement are provided to meet the needs of patients with severe and enduring mental illness with complex needs.