[21] Depression Flashcards
What is the problem with depression in palliative care?
It is common, but under-reported, under-assessed, and under-treated
Who can get depressed in palliative disease?
Any patient
What patients are at higher risk of depression in palliative care?
- Past history of depression
- Younger patients
- Patients with certain cancer types
- Uncontrolled pain and other symptoms
What types of cancer have an increased risk of depression?
- Lung
- Pancreas
What is the problem with depression and uncontrolled pain?
It is difficult to know if untreated pain is causing depression, or if depression is magnifying pain
How can depression make pain management more difficult?
Patients who are depressed often lose all motivation, and see little point in anything, including taking analgesia regularly or other medication
At what point in the disease process are patients more likely to get depressed?
- Initial diagnosis
- Time of diagnosis recurrence
- Time when they are told their disease is terminal
What % of patients with advanced cancer are depressed?
25%
What will happen to the mood of most patients with terminal illness?
They will feel sad
What might patients feel sad about in terminal illness?
- Life coming to an end
- Leaving loved ones
- What may happen to them as end of life approaches
What differentiates people who are sad about their terminal illness from those who are depressed?
Those who are sad will still be able to look forward to days out with family and friends, seeing visitors etc, whereas a patient who is depressed does not look forward with enjoyment to anything
Why do we need to think about depression in patients who seem to be far more unwell than their condition suggests they should be?
Because patients who are depressed are withdrawn, and often appear physically more unwell due to this
Why might screening tools be helpful for depression in terminal illness?
Many patients find it difficult to say they are depressed or to find the words to describe how they feel
What tools may be helpful for screening for depression in advanced cancer?
- Brief Edinburgh Depression Scale (BEDS)
- PHQ9 depression scale
What is the advantage of the BEDS?
It is quick and easy to use, with only 6 questions
