Depression & Palliative Care

Life threatening illness often results in depression but talking to the doctor can help

(RxWiki News) Communicating psychological pain to doctors is just as important as reporting physical pain when being treated with palliative care. It’s vital for doctors to know if the patient is facing depression.

A recent study found that physicians treating palliative care patients don’t use a standard clinical test for depression.  

Physicians reported they took patient's background and overall medical situation into context when assessing their palliative patient's level of depression.

"Tell your doctor if you’re feeling depressed."

Franca Warmenhoven, MD, from the department of primary and community care at Radboud University Nijmegen Medical Centre, The Netherlands, led a team to interview 22 family physicians to see how they approached dealing with depression in their palliative care patients.

Palliative care focuses on improving the quality of life for patients facing terminal illness. It is a medical team approach that acts as a support network.

Psychological and emotional care is factored in with physical care for patients and their families.

In the study, the physicians described treating palliative care patients who showed symptoms of depression as, “a continuous and overlapping process.”

One of the most important things the physicians had to figure out was whether their patients were experiencing “normal” sadness vs. depression.

The physicians reported that when determining “normal” sadness or depression they could not strictly rely on criteria for depression, but rather had to use their clinical judgment. This judgment included the context of the patient's situation and background as well.

The use of antidepressants was rare as a treatment for depression in these cases. Physicians admitted they relied heavily on honest communication from their patients about their emotional state.

Authors said, “Depression in palliative care is associated with poor treatment adherence, increased difficulties in relieving physical symptoms, disability, poor prognosis, higher mortality, longer inpatient stays and elevated healthcare costs.”

Palliative care is patient-centered care. Communication between patient and doctor and among all healthcare professionals involved is paramount.

Authors recommended intensive support from the healthcare professionals and frequent visits and open communication from the patients to recognize and manage depression in palliative care patients. 

This study was published in the July/August issue of the Annals of Family Medicine. No financial information was given and no conflicts of interest were found.

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Review Date: 
July 24, 2012