Presentation and management of depression in people with learning disability

The occurrence of depression in people with learning disability is not a late-20th century phenomenon. Reports were first published in the 1800s describing the existence of depression in individuals with intellectual impairment (Clouston, 1883). However, as we enter a new millennium, the appropriate diagnosis, assessment and treatment of depression, and indeed all forms of mental illness in people with learning disability, will become the focus of considerable concern for all professionals working in this field. With recent national trends towards de-institutionalisation, referral of individ uals with learning disability to psychiatrists to 'rule out a possible depressive illness' and to 'advise about further treatment' will increase. It remains