Fear, Anxiety and Adjustment Disorder in PC

Question 1

Depression, anxiety, adjustment disorder and hopelessness

What percentage of patients in PC report feelings of depression? And what percentage of patients in PC report anxiety?

Answer 1

Depression in PC 30%
Anxiety in PC 10%

Question 2

Fear, anxiety, and adjustment disorder in PC

Name some therapeutic approaches to existential threat (fear of death)

Answer 2

1. Social interaction- companionship - ‘you are a value to other people’
2. Living in the present- as opposed to the future
3. Maintaining daily routines
4. Music Therapy
5. Managing Cancer and Living Meaningfully (CALM) intervention-requires prognosis >1 year

Lee- wanted to eat and ‘be normal’ despite n/v’ did daytrips in summer

Question 3

Therapeutic approaches to depression, anxiety, adjustment disorder and hopelessness.

Answer 3

1. Cognitive behavioral-based therapies
2. Mindfulness-based interventions
3. Meaning-based intervention

Question 4

Depression, anxiety, adjustment disorder and hopelessness

Define adjustment disorder

Answer 4

DSM V diagnostic criteria:
Emotional or behavioral sx develop in response to identifiable stressor(s) within 3 months of the onset of stressor(s) PLUS either or BOTH
1) marked distress that is out of proportion to the severity or intensity of the stressor
2) The stress related disturbance does not meet criteria for another mental health disorder

Question 5

Depression, anxiety, adjustment disorder and hopelessness

For adjustment disorder, what is a key predictor of prevalence?

Answer 5

Decrease in social functioning

Question 6

Fear, anxiety, and adjustment disorder in PC

What therapeutic approaches can be beneficial in someone with Fear of disease progression?

Answer 6

1) The Munich Approach- CBT

Question 8

Coping and resilience in palliative medicine

Coping

Answer 8

Thoughts and behaviors that people use to manage the internal and external demands of situations that are appraised as stressful.

Question 9

Coping and resilience in palliative medicine

Name 4 coping strategies

Answer 9

1) Problem-focused coping
2) Emotion-focused coping
3) Meaning-focused coping
4) Religious & spiritual coping

Coping measurement tool: COPE scale

Question 10

Coping and resilience in palliative medicine

Maladaptive coping styles are those that stand in the way of adjustment to the stressor. What is likely the worst consequence of a stressful health event?- It also predicts suicidal ideation.

Answer 10

Hopelessness- negative view of the future, sense of loss of control, confidence, and the ability to achieve personal goals
Hopelessness predicts suicidal ideation and desire to hasten death