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The prevalence of psychiatric disorder and the wish to hasten death among terminally ill cancer patients

Published online by Cambridge University Press:  04 April 2005

BRIAN J. KELLY ,
DAN PELUSI ,
PAUL C. BURNETT  and
FRANCIS T. VARGHESE
BRIAN J. KELLY
Affiliation:
Centre for Rural & Remote Mental Health, University of Newcastle, Orange, Australia
DAN PELUSI
Affiliation:
University of Queensland, Department of Psychiatry, Princess Alexandra Hospital, Brisbane, Australia
PAUL C. BURNETT
Affiliation:
Centre of Research & Graduate Studies, Charles Sturt University, Wagga Wagga, Australia
FRANCIS T. VARGHESE
Affiliation:
University of Queensland, Department of Psychiatry, Princess Alexandra Hospital, Brisbane, Australia
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Abstract

Objective: This study assessed the prevalence of psychiatric disorder among a group of terminally ill cancer patients with or without a wish to hasten death (WTHD).

Methods: Consecutive patient referrals to a hospice inpatient unit, home palliative care service, and hospital palliative care-consulting service were recruited. A group of these patients (n = 56) consented to participate in a structured clinical interview (SCID) to identify the presence of psychiatric diagnoses. Patients were categorised into those with or without a wish to hasten death.

Results: Current major depressive episode and adjustment disorder were the most prevalent disorders in this group of patients. Patients with a high WTHD were significantly more likely to have a current major depressive episode compared to patients with no WTHD. Patients with a high WTHD were also significantly more likely to have a past major depressive episode compared to patients with no WTHD.

Significance of results: These results support the view that terminally ill patients with a high WTHD are significantly more likely to be suffering from a depressive disorder as assessed by a structured clinical interview. This has important clinical implications for those caring for dying patients who may make a request to hasten death.

Keywords

EuthanasiaPhysician-assisted suicideDepressionPsychiatric diagnosisStructured clinical interview
Type
Research Article
Information
Palliative & Supportive Care , Volume 2 , Issue 2 , June 2004 , pp. 163 - 169
Copyright
© 2004 Cambridge University Press

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References

REFERENCES

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). Washington, DC: American Psychiatric Association.
Block, S. (2000). Assessing and managing depression in the terminally ill patient. Annals of Internal Medicine, 132, 209–218.Google Scholar
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. Journal of the American Medical Association, 284, 2907–2911.Google Scholar
Brugha, T. (1993). Depression in the terminally ill. British Journal of Hospital Medicine, 50, 175–181.Google Scholar
Chochinov, H. (2001). Depression in cancer patients. Lancet, 2, 499–505.Google Scholar
Chochinov, H., Wilson, K.G., Enns, M., et al. (1994). Prevalence of depression in the terminally ill: Effects of diagnostic criteria and symptom threshold judgments. American Journal of Psychiatry, 151, 537–540.Google Scholar
Chochinov, H., Wilson, K.G., Enns, M., et al. (1995). Desire for death in the terminally ill. American Journal of Psychiatry, 152, 1185–1191.Google Scholar
Derogatis, L.R., Morrow, G.R., Fetting, J., et al. (1983). The prevalence of psychiatric disorders among cancer patients. Journal of the American Medical Association, 249, 751–757.Google Scholar
Durkin, I., Kearney, M., & O'Siorain, L. (2003). Psychiatric disorder in a palliative care unit. Palliative Medicine, 17, 212–218.Google Scholar
First, M., Spitzer, R., Gibbon, M., et al. (1998). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute.
Ganzini, L., Fenn, D., Lee, M., et al. (1996). Attitudes of Oregon psychiatrists toward physician-assisted suicide. American Journal of Psychiatry, 153, 1469–1475.Google Scholar
Ganzini, L. & Lee, M. (1997). Psychiatry and assisted suicide in the United States. New England Journal of Medicine, 336, 1824–1826.Google Scholar
Kelly, B., Burnett, P., Pelusi, D., et al. (2003). Factors associated with the wish to hasten death: A study of patients with terminal illness. Psychological Medicine, 33, 75–81.Google Scholar
Kissane, D., Street, A., & Nitschke, P. (1998). Seven deaths in Darwin: Case studies under the Rights of the Terminally Ill Act, Northern Territory, Australia. Lancet, 352, 1097–1102.Google Scholar
Lloyd-Williams, M. (2001). Screening for depression in palliative care patients: A review. European Journal of Cancer Care, 10, 31–35.Google Scholar
Lloyd-Williams, M., Spiller, J., & Ward, J. (2003). Which depression screening tools should be used in palliative care? Palliative Medicine, 17, 40–43.Google Scholar
Maguire, P. (1985). Improving the detection of psychiatric problems in cancer patients. Social Science & Medicine, 20, 819–823.Google Scholar
Maguire, P. & Howell, A. (1995). Improving the psychological care of cancer patients. In Psychiatric Aspects of Physical Disease, Houses, A. & Mayou, R. (eds.), pp. 41–54. London: Royal College of Psychiatry.
Minagawa, H., Uchitomi, Y., Yamawaki, S., et al. (1996). Psychiatric morbidity in terminally ill cancer patients: A prospective study. Cancer, 78, 1131–1137.Google Scholar
Portenoy, R., Thaler, H., Kornblith, A., et al. (1994). The memorial symptom assessment scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A, 1326–1336.Google Scholar
Saranson, I., Levine, H., Basham, R., et al. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44, 127–139.Google Scholar
Wilson, K.G., Scott, J.F., Graham, I.D., et al. (2000). Attitudes of terminally ill patients toward euthanasia and physician-assisted suicide. Archives of Internal Medicine, 160, 2454–2460.Google Scholar
Zigmond, A. & Snaith, R. (1983). The hospital anxiety and depression scale. Acta Psychiatry Scandinavia, 67, 361–370.Google Scholar