[Occurrence and diagnosis of psychiatric conditions in palliative medicine]

The aims of the study are to describe the prevalence of psychiatric disorders in palliative care and how to diagnose these disorders.

Literature search including cancer patients, palliative care, psychiatric conditions and diagnostics.

Neuropsychiatric conditions such as delirium, dementia and amnestic disorder are prevalent (> 20%), especially in the terminal phase. Anxiety and depressive symptoms are also common and may be caused by the patients' medical condition. Probably less than 10% have anxiety or depressive disorders. However, methodological limitations make comparisons across studies difficult. The interview is the main basis for assessment of mental status. Doctor-centered interviewing techniques are needed in the assessment of neuropsychiatric disorders. Emotional symptoms are best explored by open-ended questions and facilitating techniques. Psychiatric somatic symptoms such as weight loss, fatigue or insomnia are not valid diagnostic criteria. Selfreport questionnaires and short-form screening instruments are best suited for monitoring the course of the disorders, but must be adapted for this specific population.

Neuropsychiatric conditions are the most prevalent psychiatric disorders in palliative care. Good interviewing skills are the main element in the diagnostic workup.