Psychiatric disorder in a palliative care unit

Durkin, Ita; Kearney, Michael; O'Siorain, L

doi:10.1191/0269216303pm670oa

Cited by 50 publications

(49 citation statements)

References 18 publications

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“…A further 113 papers were removed as they did not report primary research data and/or prospectively measure prevalence or incidence rates of delirium in adult specialist palliative care inpatient units, leaving six papers. Two additional papers 35,36 were identified from a hand search of the reference lists of the eligible papers and other reviews. 1,3 At the end of the search, eight studies that prospectively measured the prevalence or incidence of delirium in specialist palliative care adult inpatient settings remained (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…1,3 At the end of the search, eight studies that prospectively measured the prevalence or incidence of delirium in specialist palliative care adult inpatient settings remained (Table 1). 4,5,[35][36][37][39][40][41] These included studies which were conducted in the northern hemisphere over a 12-year period (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008).…”

Section: Resultsmentioning

confidence: 99%

“…The included studies were undertaken in patient settings described variously as hospices (n = 2), 39,41 palliative care units (n = 3), [35][36][37] acute palliative care units (n = 2), 4,40 and a combined acute palliative care unit/hospice (n = 1). 5 Where described, the purpose of the settings included symptom control, respite, rehabilitation, and/or terminal care for palliative care patients.…”

Section: Setting Diagnosis and Demographicsmentioning

confidence: 99%

“…The majority (98.9%) of all participants (n = 1079) across these studies had advanced cancer, with some diagnoses not specified in one study. 41 Two studies included participants with other life limiting diseases: (a) immunodeficiency disorders (n = 11) 36 and (b) end-stage cardiac failure and cerebrovascular disease (n = 1). 41 Across the studies, there was equal representation of males and females, with a mean age of 66.24 years (range 62-68.7 years).…”

Section: Setting Diagnosis and Demographicsmentioning

confidence: 99%

“…Delirium occurrence was measured at different frequencies and points of time during the admission, while five studies measured both delirium prevalence and incidence. 4,35,36,39,41 Different criteria were used to define the terminal stage, with the last weeks of life considered the "pre-terminal and terminal" stage of cancer in two studies. 5,39 "Terminally ill" or "terminal" cancer patients were elsewhere considered to be within the last 6 months of life.…”

Section: Study Characteristics Design Quality and Focusmentioning

confidence: 99%

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Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

et al. 2012

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Background: Delirium is a serious neuropsychiatric syndrome frequently experienced by palliative care inpatients. This syndrome is under-recognized by clinicians. While screening increases recognition, it is not a routine practice. Aim and design: This systematic review aims to examine methods, quality, and results of delirium prevalence and incidence studies in palliative care inpatient populations and discuss implications for delirium screening. Data sources: A systematic search of the literature identified prospective studies reporting on delirium prevalence and/or incidence in inpatient palliative care adult populations from 1980 to 2012. Papers not in English or those reporting the occurrence of symptoms not specifically identified as delirium were excluded. Results: Of the eight included studies, the majority (98.9%) involved participants (1079) with advanced cancer. Eight different screening and assessment tools were used. Delirium incidence ranged from 3% to 45%, while delirium prevalence varied, with a range of: 13.3%-42.3% at admission, 26%-62% during admission, and increasing to 58.8%-88% in the weeks or hours preceding death. Studies that used the Diagnostic and Statistical Manual-Fourth Edition reported higher prevalence (42%-88%) and incidence (40.2%-45%), while incidence rates were higher in studies that screened participants at least daily (32.8%-45%). Hypoactive delirium was the most prevalent delirium subtype (68%-86% of cases). Conclusion: The prevalence and incidence of delirium in palliative care inpatient settings supports the need for screening. However, there is limited consensus on assessment measures or knowledge of implications of delirium screening for inpatients and families. Further research is required to develop standardized methods of delirium screening, assessment, and management that are acceptable to inpatients and families.Palliative Medicine 27(6) 486 -498

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Setting Diagnosis and Demographicsmentioning

confidence: 99%

Section: Setting Diagnosis and Demographicsmentioning

confidence: 99%

Section: Study Characteristics Design Quality and Focusmentioning

confidence: 99%

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Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

et al. 2012

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Do rates of mental disorders and existential distress among advanced stage cancer patients increase as death approaches?

et al. 2008

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Objective To determine if the prevalence of mental disorders and related factors increase as advanced cancer patients get closer to death. Method Baseline, cross-sectional data from 289 patients who were assessed prior to their death as part of a multi-site, longitudinal, prospective cohort study of advanced cancer patients. Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, and Posttraumatic Stress Disorder were assessed using the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I). Other factors examined included existential well-being, patient grief about their illness, physical symptom burden, terminal illness acknowledgment, peacefulness, and the wish to live or die. Results Closeness to death was not associated with higher rates of mental disorders. Patients closer to death exhibited increased existential distress and physical symptom burden, were more likely to acknowledge being terminally ill, and were more likely to report an increased wish to die. Conclusion Results do not provide support for the common clinical assumption that the prevalence of depressive and anxiety disorders increases as death nears. However, patients' level of physical distress, acknowledgment of terminal illness, and wish to die, possibly reflecting acceptance of dying, increased as death approached. Longitudinal studies are needed to confirm individual changes in rates of mental disorder as patients approach death.

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Depression experienced by young women newly diagnosed with breast cancer

2005

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Breast cancer is the most common type of cancer among women. While almost a quarter of women diagnosed with breast cancer are 50 or younger, few studies are focused on them. Compared to older women, young women have more difficulty adjusting to the breast cancer diagnosis, report more symptoms of distress and a lower quality of life. This study examined depressive symptoms among an ethnically diverse sample of 331 young women, newly diagnosed with breast cancer. The focus was to determine the relative importance of biological, psychological and social variables as correlates of their level of depression. A hierarchical multiple regression analysis indicated that a model combining these variables is more highly correlated with depressive symptoms than using biological, psychological or social variables separately. Single measures including bodily pain, self-esteem, level of emotional support and age had independent effects in the combined regression model. Early intervention may prevent these biopsychosocial symptoms progressing to major depression and, thus, enhance the quality of life.

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Psychiatric disorder in a palliative care unit

Cited by 50 publications

References 18 publications

Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review

Do rates of mental disorders and existential distress among advanced stage cancer patients increase as death approaches?

Depression experienced by young women newly diagnosed with breast cancer

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