2010

Authors

  • Kay Porche Kay Porche
  • Liz Reymond Liz Reymond
  • John O'Callaghan John O'Callaghan
  • Margaret Charles Margaret Charles

Objective To explore the practices of members of the Australian and New Zealand Society of Palliative Medicine (ANZSPM) in assessing and treating depression in palliative care patients. Methods Semistructured questionires were forwarded to ANZSPM members in consecutive mail-outs to survey diagnostic and treatment practices for depression. Results The response rate was 62.3%. The median prevalence of depression, as perceived by respondents, in the present respondent patient populations was 20% (range 0%-90%); 57.1% of respondents always assessed for depression, whereas 42.9% assessed for depression sometimes. The majority (98.9%) of respondents relied on clinical interviews to assess depression; non-somatic symptoms of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria were more useful than somatic symptoms. The depression screening tools most frequently used were one- and two-item questions. Pharmacological and non-pharmacological methods were used to treat depression, with selective serotonin reuptake inhibitors the most frequently prescribed medications. Psycho-educatiol and supportive counselling were the most frequently used non-pharmacological interventions. Nomited measures to augment depression magement included improving access to psychiatry, psychology and other allied health services, the development of a screening tool specific to palliative care patients and associated guidelines for depression magement. Conclusions This is the first Australasian study to explore the practice of medical practitioners regarding depression in palliative patients. Incorporation of screening tool questions into palliative care assessment interviews may warrant future research. What is known about the topic? Depression in palliative care patients has a negative impact on quality of life; however, little is known about how Australasian palliative care medical practitioners mage depression in this patient population. What does this paper add? To the researchers' knowledge, this is the first Australasian study that explores the practices of local palliative care specialists in the magement of depression in palliative patients. What are the implications for practitioners? Overall magement of depression in palliative care populations by Australasian practitioners is similar to that of their European colleagues. Consensus is that for assessment of depression in palliative patients, non-somatic symptoms of DSM-IV criteria are more useful than somatic symptoms. Practitioners report the need for improved access to psychiatric, psychological and other support services, for a palliative care-specific depression screening tool and for depression magement guidelines applicable to palliative care patients.