The opportunity for psychiatry in palliative care

Psychiatry Programs, The Institute for Palliative Medicine at San Diego Hospice, San Diego, California 92103, USA.
Canadian journal of psychiatry. Revue canadienne de psychiatrie (Impact Factor: 2.55). 12/2008; 53(11):713-24.
Source: PubMed


The need for psychiatrists to work with patients and families living with chronic life-threatening illnesses has never been greater. Further, psychiatrists may find exciting work within the relatively new field of palliative care, which is devoted to the prevention and relief of all suffering. Increasingly, individuals are living longer with multiple issues that cause suffering, interfere with their lives, and often lead to psychosocial sequelae. To ensure state-of-the-art care for patients and families throughout an illness and any ensuing bereavement period, many experienced psychiatrists are needed as consultants to, and as members of, interdisciplinary palliative care teams. This need presents limitless opportunities for psychiatrists to care for patients, provide education, and engage in research. The potential to make a difference is great.

1 Follower
16 Reads
  • Source
    • "Psychopharmacological agents are frequently prescribed by nonpsychiatric physicians, which further underlines the necessity of disseminating knowledge about psychiatric diseases and their treatment (Wancata et al., 1998). Our data substantiate the need for psychiatrists as consultants and as members of interdisciplinary teams in the field of palliative care (Irwin & Ferris, 2008; Jaiswal et al., 2014). The treatment of depressive comorbidities requires comprehensive knowledge of psychopharmacological substances and should be administered by doctors with suitable expertise. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Our aim was to evaluate the frequency and treatment of psychiatric symptoms in patients at palliative care units (PCUs). Method: Patients admitted to one of five participating PCUs in Austria were included. The short version of the Patient Health Questionnaire (PHQ-D) was used to evaluate their mental health status. Pain intensity was rated on a numeric rating scale (NRS) from 0 to 10 by patients and physicians. Patients with a previously diagnosed psychiatric disorder were compared to those without or with newly diagnosed psychiatric symptoms, based on PHQ-D results. Pain and psychopharmacological medication were assessed. Opioid doses were converted into oral morphine equivalents (OMEs). Results: Some 68 patients were included. Previously undetected psychiatric symptoms were identified in 38% (26 of 68), preexisting psychiatric comorbidities were evident in 25% (17), and no psychiatric symptoms were observed in 37% (25). Patients with a preexisting psychiatric comorbidity received antidepressants and benzodiazepines significantly more often than patients without or with previously undetected psychiatric symptoms (p < 0.001). Patient and physician median NRS ratings of pain intensity correlated significantly (p = 0.001). Median NRS rating showed no significant difference between patients with preexisting, previously undetected, or without psychiatric symptoms. OMEs did not differ significantly between preexisting, without, or previously undetected psychiatric symptoms. Patients with undetected and preexisting psychiatric comorbidities had a greater impairment in their activities of daily living than patients without psychiatric symptoms (p = 0.003). Significance of results: Undetected psychiatric comorbidities are common in patients receiving palliative care. Screening for psychiatric symptoms should be integrated into standard palliative care to optimize treatment and reduce the psychosocial burden of the disease.
    Palliative and Supportive Care 10/2015; DOI:10.1017/S1478951515000899 · 0.98 Impact Factor
  • Source
    • "First a more thorough assessment of the target audience is needed. Clinicians will vary in their knowledge and skills about the assessment, diagnosis , and management of psychiatric issues as they relate to patients with life-threatening illnesses (Irwin & Ferris, 2008). Nonpalliative-care physicians and other members of the general health care team will need to achieve and maintain basic core competencies in the psychiatric aspects of palliative medicine. "

    Palliative and Supportive Care 04/2009; 7(1):3-6. DOI:10.1017/S1478951509000029 · 0.98 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients with advanced illness and their caregivers are intimately familiar with the experience of grief and loss. Being diagnosed with a serious illness is often the beginning of emotional and physical losses that may end with the patient's death. Along the difficult journey through illness, patients and caregivers may develop varying degrees and types of emotional distress. Depression, severe grief reactions, and demoralization are common types of disorders experienced by patients and caregivers in the palliative care setting. While commonly recognized as separate diagnostic entities, these disorders share many symptoms, making their differentiation challenging. Accurate diagnosis is crucial because of its treatment implications. This article reviews the characteristic features of these disorders in the context of palliative and end-of-life care. Assessment and non-pharmacologic treatment modalities are presented.
Show more