What are the best ways to recognise and treat depression, anxiety and low mood in people who are dying? What are the pros and cons of different psychotherapeutic interventions, including drug therapies, and when is the best time to provide them?

Record type Uncertainties identified from clinicians' questions
Source James Lind Alliance Palliative and end of life care Priority Setting Partnership
Why is there uncertainty? Reliable up-to-date systematic reviews have revealed important continuing uncertainties about treatment effects

Original Uncertainty

Ranked 24th in the PeolcPSP

This uncertainty was identified from three professionals' questions.

This is an indicative uncertainty and the following submissions were merged to form this one:
Anxiety is a problem on its own but also decreases ability to cope with pain
How does counselling and psychotherapy help? Which kind of counselling is most effective for people in end of life care? Should counseling be available to all patients or those who cross a clinical threshold of measured distress? What's the best way to evaluate effectiveness/outcomes of intervention (especially psychological spiritual care).
Is there a way to get emotional support? My father sank into depression as the treatment for his cancer stopped working. He was particularly difficult to live with, but there didn't seem to be any support for dealing with his depression, or maybe we didn't know where to turn to. The depression was as difficult to cope with (for all of us) as the cancer was.

References to reliable up-to-date systematic reviews:

Walker J, Sawhney A, Hansen CH, Symeonides S, Martin P, Murrey G, Sharpe M. Treatment of depression in people with lung cancer: a systematic review. Lung Cancer 2013; 79: 46-53 PMID: 23102652

What is needed? Further research
Systematic reviews that need updating or extending None identified
Systematic reviews in preparation None identified
Ongoing controlled trials Intervention for treating depression among palliative care patients and their families. [See web page] CanTalk: A trail into the benefits of a talking therapy called CBT for the treatment of depression in adults with advanced cancer. ISRCTN07622709.


Which health conditions? Mental health | Service delivery, organisation and staffing | Palliative and end of life care
What is person's age? Adult
Which types of treatments? Service delivery

Which Outcomes

Patient Satisfaction; health related quality of life; health related cost;quality of care

Record ID: Publication date:08 Sep 2015
Last reviewed date:08 Sep 2016 Publication Type:Known Uncertainty
The DUETs team endeavours to ensure that information is correct at the time of data entry