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Ebook ABC of palliative care (2E): Part 2

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Nội dung chi tiết: Ebook ABC of palliative care (2E): Part 2

Ebook ABC of palliative care (2E): Part 2

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

Ebook ABC of palliative care (2E): Part 2e assessment ami management of |>syvhological ami psychiatric symptoms are still pool.A common misapprehension is to assume that depression and anxiet

y represent umletstamlable reactions to incurable illness. When cure is not possible, the analytical approach we adopt to physical and |>sychological Ebook ABC of palliative care (2E): Part 2

signs and symptoms is often forgotten. This error of approach and the Lick of diagnostic importance given to major ami minor symptoms of ileptessioii

Ebook ABC of palliative care (2E): Part 2

result ill underdiagnosis and undenreatment of psychiatric disorder.Psychological adjustment real lions aftei diagnosis or relapse often include fear,

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

Ebook ABC of palliative care (2E): Part 2professional care. However, 10-20% of patients will develop formal |>sy<'biali ic disorders that require specific evaluation and management in additio

n to general srrp|M>r I.CausesDtỹreiĩũm and anxừty arc usually reactions to the losses and lineals of the medical illness. Other risk factors often co Ebook ABC of palliative care (2E): Part 2

ntribute.Cj>nfivM>n usually reflects an organic mental disoider from one or more causes, of ten worsened by bewilderment and distress, discomfort or p

Ebook ABC of palliative care (2E): Part 2

ain, and Ireing in liltfamiliar surroundings with unfamiliar carers. Elderly patients with impaired mcmorv, (tearing, or sight are esptx’ClIly al risk

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

Ebook ABC of palliative care (2E): Part 2 of major illness•Knowledge of a life threatening diagnosis, ptognostii uncertainty, feats alxiut dying and death•Uncontrolled physical symptoms such

as pain and nausea•Unwanted effects of medical and surgical treatments•Loss of functional capacity, loss of independence, enforced changes in title•.S Ebook ABC of palliative care (2E): Part 2

piritual questions, uncertainty am! ilisttexs•Practical issues such as finance, work, housing•Changes in relationships, concern for dependants•Changes

Ebook ABC of palliative care (2E): Part 2

in IkkIv image, sexual disfunction, infertilityIl is important to recognise psychiatric disorders because, if untreated, they add to the suffering of

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

Ebook ABC of palliative care (2E): Part 2 not always |K>ssible on the basis of a single interview to distinguish self limiting distress, which forms a natural part of the adjustment process,

from the psychiatric sy ndromes of depressive illness and anxiety state, which need specific treatment. Borderline cases are common, and both the Soma Ebook ABC of palliative care (2E): Part 2

liland psychological symptoms of depression and anxiety can make diagnosis difficult.Somatic iymptomi—Depression may manifest itself as intractable pa

Ebook ABC of palliative care (2E): Part 2

in, while anxiety ran manifest itself as nausea or dyspnoea. Such symptoms may seem disproportionate to the medical pathology and respond poorly to me

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

Ebook ABC of palliative care (2E): Part 2ss. Depressed patients seem to loathe themselves, over and above loathing their disease. A useful analogy is that the patient who is still blames the

illness for how they feel, whereas a patient who is depressed blames themselves for their illness. This expresses itself through guilt alxmt being ill Ebook ABC of palliative care (2E): Part 2

and a burden to others, pervasive loss of interest and pleasure, and hopelessness about the future. Attempted suicide or requests for euthanasia, how

Ebook ABC of palliative care (2E): Part 2

ever rational they might seem, invariably indicate clinical depression. It is important that such thoughts arc elicited—for example, by asking “have y

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

Ebook ABC of palliative care (2E): Part 2al symptoms•Poor relationships and communication between staff and pauent•Unwanted effects of medical and surgical treatments•I lisroty of mood ilismd

rr or misuse of alcohol or thugs•Personality Hairs hindering adjustment, such as rigidity, pessimism, extreme need for independence and control•Concur Ebook ABC of palliative care (2E): Part 2

rent life events or social difficulties•Lack of support from family and friendsCommon causes of organic mental disorders•Prescribed drugs—opioids, psy

Ebook ABC of palliative care (2E): Part 2

chotropic drugs, corticosteroids, some cytotoxic drugs•Infection—respiratory or urinary infection, septiraetnia•Macroscopic brain pathology—primary or

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

Ebook ABC of palliative care (2E): Part 2ilure•Drug withdrawal—licnzodiazepincs, opioids, alcohol

9 Depression, anxiety, and confusionMari Lloyd-WilliamsDespite many advances in the palliation and management of the symptoms of advance*! cancer, the

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