Best Practices for the Nonpharmacological Treatment of Depression at the End of Life

Abstract

This literature review summarizes the current research on nonpharmacological management of depressive symptoms for patients nearing the end of their lives. Research suggests that major depressive disorder may affect terminally ill adults at a disproportionately high rate. Psychotherapy has not been shown to have consistent benefits among patients in the final months of life. Semi-psychotherapeutic (life review) techniques are likely most effective in patients in the final weeks of life. Non-psychotherapeutic techniques such as hypnotherapy have not been studied sufficiently to be recommended as first-line treatments. Based on the current research, it is our recommendation that psychotherapy be used first-line in patients with approximately 6 months or more to live, and that semi-psychotherapeutic techniques be first-line in patients with 6 months or less to live.