Depression matters - we should ask about it

by Kristina Newport, MDAs we care for patients with serious illness, we frequently encounter depressed mood. Multiple studies have shown depression independently contributes to morbidity and mortality, and yet most of us do not systematically screen for it. This is again illustrated in Lloyd-Williams’ et. al recent study of 629 patients with advanced cancer attending palliative care day centers in England. Patients in this study identified as moderately to severely depressed on the PHQ-9 died three weeks sooner than those with no or only mild depression. A similar result was identified in patients who reported consideration of self-harm. Notably, in the majority of cases, involved health care providers did not know of their patient’s self-harm thoughts. I don’t think this is unique to palliative care centers in England. The complexity of differentiating depression from symptoms of serious illness interferes with diagnosis. (See Fast Fact #7 - Depression in Advanced Cancer ). We, as a field, have not yet decided upon a simple tool that can be used to screen for depression or standardization of when it should be completed. (Although some helpful suggestions are found on Fast Fact 146 - Screening for Depression in Palliative Care ). Also, it can be a helpless feeling to identify a depressed patient when their treatment options for the depression may be very limited due to short prognosis and multiple, irreversible, contributing factors. So while there is no si...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Carer Workers Tags: depression newport psych Source Type: blogs