Palliative care psychiatry

Psychiatrists working in palliative care see a wide variety of diagnoses in the setting of advanced disease and bereavement. This article describes the key features of palliative care and some of the specific presentations of psychiatric disorders in this setting, including withdrawal, requests for physician-assisted suicide or euthanasia, assessment of mental capacity, and patients with denial about their disease and its poor prognosis. The remainder of the chapter describes the problem of depression in the context of advanced disease. This includes a discussion of definitions and diagnosis, the potential adverse consequences of depression, and the assessment and management of depression.