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Case 14 - “My Soul Is in England”

Treatment of Depression and Anxiety at End of Life

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

The primary care provider is often the first clinician to recognize the high burden of life-prolonging treatment for a resident who has limited life expectancy and high medical and neurocognitive comorbidity. Palliative care refers to specialized medical care provided to individuals with serious illnesses or conditions that are not curable. The goal of palliative care is to improve the quality of life for patients by alleviating symptoms, managing pain, and addressing the physical, emotional, social, and spiritual needs associated with their condition. Clinical depression is relatively common at the end of life. The prevalence of major depressive disorder at the end of life for cancer patients is estimated to be between 5-20%. Choose psychotropic medications that have a quicker response time when possible. Examples include stimulants for depressive symptoms and benzodiazepines for anxiety.  SSRI’s, SNRI’s, and other more commonly prescribed medications for depression and anxiety may take up to four to six weeks for clinical response.

Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 68 - 72
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Rosenstein, D. L. (2011). Depression and end-of-life care for patients with cancer. Dialogues in Clinical Neuroscience, 13 (1), 101108. https://doi.org/10.31887/DCNS.2011.13.1/drosensteinCrossRefGoogle ScholarPubMed

Further Reading

Almeida, S. S., Zizzi, F. B., Cattaneo, A., Comandini, A., Dato, G. D., Lubrano, E., Pellicano, C., Spallone, V., Tongiani, S., & Torta, R. (2019). Management and treatment of patients with major depressive disorder and chronic diseases: A multidisciplinary approach. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.542444Google Scholar
Desai, A., & Grossberg, G. (2017). Psychiatric Consultation in Long-Term Care (A Guide for Healthcare Professionals). (Cambridge University Press.) Kindle Edition. p. 118.CrossRefGoogle Scholar
Khouzam, H. R. (2016). Psychopharmacology of chronic pain: A focus on antidepressants and atypical antipsychotics. Postgraduate Medicine, 128 (3), 323330.CrossRefGoogle ScholarPubMed
Smith, H. R. (2015). Depression in cancer patients: Pathogenesis, implications and treatment. Oncology letters, 9 (4), 15091514.CrossRefGoogle ScholarPubMed
Walker, J., Hansen, C. H., Martin, P., Sawhney, A., Thekkumpurath, P., Beale, C., & Sharpe, M. (2013). Prevalence of depression in adults with cancer: A systematic review. Annals of oncology, 24 (4), 895900.CrossRefGoogle ScholarPubMed
Yang, X., Wu, X., Gao, M., Wang, W., Quan, L., & Zhou, X. (2020). Heterogeneous patterns of posttraumatic stress symptoms and depression in cancer patients. Journal of Affective Disorders, 273, 203209.CrossRefGoogle ScholarPubMed

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  • “My Soul Is in England”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.015
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  • “My Soul Is in England”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.015
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • “My Soul Is in England”
  • Matthew Gibfried, Saint Louis University School of Medicine, Missouri, George T. Grossberg, Saint Louis University School of Medicine, Missouri
  • Book: Clinical Case Studies in Long-Term Care Psychiatry
  • Online publication: 31 October 2024
  • Chapter DOI: https://doi.org/10.1017/9781108630344.015
Available formats
×