Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T22:14:30.548Z Has data issue: false hasContentIssue false

Clinical assessment of depression in terminally ill cancer patients: A practical guide

Published online by Cambridge University Press:  13 April 2006

HAYLEY PESSIN
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
MEGAN OLDEN
Affiliation:
Department of Psychology, Fordham University, Bronx, New York, USA
COLLEEN JACOBSON
Affiliation:
Department of Child and Adolescent Psychiatry, Columbia University/New York State Psychiatric Institute, New York, New York, USA
ANNE KOSINSKI
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

Abstract

Depression is commonly experienced by cancer patients at the end of life. The identification of patients suffering from depression is essential to provide clinicians with an opportunity to relieve considerable suffering. However, the assessment of depressive symptoms is complex and often challenging in a terminally ill cancer population. This article offers practical guidelines to assist clinicians with the diagnosis of depression, reviews the defining symptoms of depression and their unique presentation in patients at the end of life, suggests modifications of the standard diagnostic interview, and provides examples of specific assessment questions to target depressive symptoms at the end of life.

Type
REVIEW ARTICLES
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.) Washington, DC: American Psychiatric Association.
Block, S. (2000). Assessing and managing depression in the terminally ill patient. Annals of Internal Medicine, 132, 209218.Google Scholar
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA, 284, 29072911.Google Scholar
Bukberg, J., Penman, D., & Holland, J. (1984). Depression in hospitalized cancer patients. Psychosomatic Medicine, 46, 199212.Google Scholar
Casey, J. (1994). Depression in the dying—Disorder or distress? Progressive Palliative Care, 2, 13.Google Scholar
Cassem, E.H. (1990). Depression and anxiety secondary to medical illness. The Psychiatry Clinics of North America, 13, 597612.Google Scholar
Chochinov, H.M., Wilson, K.G., Enns, M., et al. (1998). Depression, hopelessness, and suicidal ideation in the terminally ill. Psychosomatics, 39, 366370.Google Scholar
Cohen-Cole, S. & Stoudemire, A. (1987). Major depression and physical illness: Special considerations in diagnosis and biologic treatment. Psychiatric Clinics of North America, 10, 117.Google Scholar
Endicott, J. (1984). Measurement of depression in patients with cancer. Cancer, 53, 22432248.Google Scholar
Lloyd-Williams, M. (2003). Depression—The hidden symptom in cancer. Journal of the Royal Society of Medicine, 96, 577581.Google Scholar
Massie, M.J. & Shakin, E.J. (1993). Management of depression and anxiety in cancer patients. In Psychiatric Aspects of Symptom Management in Cancer Patients, Breitbart, W. & Holland, J. (eds.), pp. 121. Washington, DC: American Psychiatric Press.
Passik, S.D., Lundberg, J., Rosenfeld, B., et al. (2000). Factor analysis of the Zung Self-Rating Depression Scale in a large ambulatory sample of oncology patients. Psychosomatics, 41, 121127.Google Scholar
Pessin, H., Rosenfeld, B., & Breitbart, W. (2002). Assessing psychological distress near the end of life. American Behavioral Scientist, 46, 357372.Google Scholar
Potash, M. & Breitbart, W. (2002). Affective disorders in advanced cancer. Hematology/Oncology Clinics of North America, 16, 671700.Google Scholar
Rosenfeld, B., Abbey, J., & Pessin, H. (2006). Depression and hopelessness near the end of life: Assessment and treatment. In Psychosocial Issues near the End of Life: A Resource for Professional Care Providers, Werth, J.L. & Blevins, D. (eds.), pp. 163182. Washington, DC: American Psychological Association.
Stiefel, F.C., Kornblith, A.B., & Holland, J.C. (1990). Changes in the prescription patterns of psychotropic drugs for cancer patients during a 10-year period. Cancer, 65, 10481053.Google Scholar
Storey, P. & Knight, C.F. (1997). UNIPAC Two: Alleviating psychological and spiritual pain in the terminally ill. Gainsville, Florida: American Academy of Hospice and Palliative Medicine.
Wilson, K.G., Chochinov, H.M., de Faye, B.J., et al. (2000). Diagnosis and management of depression in palliative care. In Handbook of Psychiatry in Palliative Medicine, Chochinov, H.M. & Breitbart, W. (eds.), pp. 2549. New York: Oxford University Press.