Distress in palliative care patients: Developing patient-centred approaches to clinical management

  • Mari Lloyd-Williams
    Corresponding author: Tel.: +44 0 151 794 5605; fax: +44 0 151 794 4709.
    Academic Palliative and Supportive Care Studies Group, University of Liverpool, School of Population, Community and Behavioural Sciences, 2nd Floor Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK
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  • Joanne Reeve
    Academic Palliative and Supportive Care Studies Group, University of Liverpool, School of Population, Community and Behavioural Sciences, 2nd Floor Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK
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  • David Kissane
    Alfred P. Sloan Chair, Attending Psychiatrist and Chairman, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, United States

    Weill Medical College of Cornell University, New York, United States
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Published:March 25, 2008DOI:


      It is widely recognised by clinicians that depression is a difficult symptom to identify amongst patients with advanced illness. Many of the symptoms of depression are difficult to elicit in patients who are approaching the end of life. Additionally, many believe that a ‘degree’ of depression is almost normal as patients approach life’s end. More recently the concept of demoralization as a separate entity to depression has been described which can be briefly described as a disorder of meaning and hope. In this paper, we review these diagnoses together with the latest screening tools which can help clinicians to recognise better such pathologies in their patients and discuss interventions that can be utilised to help patients with depression or demoralization to have a better quality of life.


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