[When the soul shatters]

Clinically relevant psychiatric disorders are very common in palliative medicine. Depending on severity, their influence on the patient's quality of life can be very unfavorable. Because of the fact that mental disorders usually have multifactor roots, an interdisciplinary approach to diagnostic and treatment procedures is necessary. In our daily clinical work we are often far away from realizing this approach. While treating these patients, the doctor is often left alone and feels powerless. The following remarks are meant as an aid to the doctor working in the field of palliative medicine, to enable him to recognize the psychiatric disorder and treat the illness accordingly. Besides the clinically relevant psychiatric disorders, many other psychological and social problems and also spiritual aspects are to be kept in mind when caring for these chronically ill patients. Due to lack of space it will not be possible to deal with all of these important issues in this paper.