Palliative Medicine
eISSN: 2081-2833
ISSN: 2081-0016
Medycyna Paliatywna/Palliative Medicine
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abstract:
Guidelines/recommendations

Depression in palliative care

Michał Pałuchowski
1
,
Agnieszka Floriańczyk
1
,
Szymon Dumański
1
,
Katarzyna Giemza
1
,
Maciej Sulerzycki
1
,
Katarzyna Pomykała
1
,
Marcin Janecki
2
,
Tomasz Dzierżanowski
1

  1. Klinika Medycyny Paliatywnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska
  2. Zakład Medycyny i Opieki Paliatywnej, Śląski Uniwersytet Medyczny w Katowicach, Polska
DOI: https://doi.org/10.5114/mp.2025.154775
Online publish date: 2025/09/28
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Depression represents a frequent and serious burden for patients in palliative care, significantly

impairing their quality of life. The aim of this paper is to provide a comprehensive characterization

of depression among palliative care patients, including an analysis of demographics, risk factors,

diagnostic difficulties, screening tools and available pharmacological and psychotherapeutic treat

ments. Depression among palliative care patients is relatively common and has a negative impact

on the patient’s ability to interact with relatives and organize their life affairs. Key risk factors

include increased pain, history of depressive disorders, severity of illness and low levels of social

support. Diagnosis is complicated by the need to differentiate with bereavement, the HADS-D

scale is the most useful in this group of patients. Classical antidepressants have moderate results

in this group of patients, instead, substances with a faster onset of action such as mirtazapine,

ketamine, and potentially methylphenidate, are particularly useful. Psychotherapy is effective.

Mindfulness practice and types of therapy dedicated especially to working with patients in termi

nal state such as dignity therapy and therapeutic life review are more successful than cognitive-

behavioural therapy.
keywords:

psychotherapy, palliative care, drug therapy, depressive disorder
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