[Depression in palliative care: prevalence and assessment]

Area of Science:

• Palliative Care Medicine
• Psychiatry
• Clinical Psychology

Context:

• Depression is the most prevalent mental health issue in palliative care, frequently misunderstood and undertreated.
• Psychological distress significantly impacts patient and family quality of life, exacerbating pain and increasing risks of suicide and hastened death.
• Accurate assessment of depression in terminally-ill patients is challenging due to overlapping somatic symptoms.

Purpose:

• To review various methods for assessing depression in palliative care settings.
• To highlight the importance of comprehensive psychiatric history and risk factor evaluation.
• To discuss the utility of the Hospital Anxiety and Depression Scale (HADS) and other assessment approaches.

Summary:

• The article examines depression assessment in palliative care, contrasting categorical and dimensional approaches.
• It discusses the Hospital Anxiety and Depression Scale (HADS), validated in Portuguese populations, as a tool that mitigates the impact of somatic symptoms.
• Other methods reviewed include single-item vs. two-item questions, structured interviews, and diagnostic criteria.

Impact:

• Emphasizes the need for clinicians to develop psychological competencies for better patient and family care.
• Aims to improve the recognition and management of depression, thereby enhancing quality of life and comfort for terminally-ill patients.
• Advocates for state-of-the-art clinical skills to address the complex psychological needs in advanced disease.