Depression in Palliative Care

Abstract

Depression is a frequent comorbidity in palliative care with significant impact on self perceived quality of life of patients and family members. Distinct phenomena in palliative care situations can be observed: from "normal" response to the diagnosis of a life threatening illness (sadness, anger, despair) to severe depressive episodes. Due to symptom overlap in regard of somatic disease and depression (e.g. fatigue, lack of appetite) current criteria for depression from ICD- 10 (or DSM IV) may not be applicable in palliative situations. Consecutive symptoms of far advanced illness/ disease therefore need to be excluded or carefully taken into consideration. There is evidence that best palliative care is one of most promising interventions to prevent depression. Drug therapy with antidepressants or other medication alone cannot be recommended but need to be complemented by non- pharmacological interventions. Apart from treatment goals survival prognosis is one of the major factors for any care plan.