Question. Are you aware of any fairly recent articles or publications dealing with the evaluation and treatment of depression in the medically ill, the terminally ill, the dying, the hospice patient, etc.? I would appreciate any information you might have available.
Answer. There are numerous articles and studies on evaluating and treating depression in the medically ill. You may be interested in seeing the entire October, 1994 issue of Psychiatric Annals, which describes how depression may be mimicked by, and coincident with, a wide variety of medical and neurological disorders. More recently, the journal CNS Spectrums (April 1999) devoted its entire issue to “Psychiatric Aspects of Medical Illness.” There is also a fine article by Pierce and Glassman on “Treatment of depression in patients with heart disease”, in the May 1998 issue of the Journal of Practical Psychiatry and Behavioral Health.
Regarding the terminally ill, you may want to see the article by Block, from Dana-Farber Cancer Institute, on assessing and managing depression in the terminally ill patient. This is published in the Feb. 2000 issue of the Annals of Internal Medicine. One of the interesting points made in the Block article is that terminally ill patients usually do not have sustained suicidal ideation; and that when they do, an evaluation for depression should be carried out. Treatment in such cases may improve the quality of life in depressed, terminally ill patients