Depression near the end of life
Telling depression from sadness, demoralisation and the physical effects of dying, screening questions that work, which antidepressant suits a short prognosis, psychostimulants, drug interactions in cancer, and when to bring in psychiatry.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- About 14% of people in palliative care have DSM major depression, with similar rates of adjustment disorder (Mitchell 2011). It is missed often, because sadness is seen as expected.
- Depression is not a normal part of dying. It worsens pain, reduces the ability to say goodbye, drives requests for hastened death and is treatable.
- The physical symptoms of depression overlap with advanced illness. Lean on anhedonia, hopelessness, guilt and worthlessness.
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Sources
- Therapeutic Guidelines: Palliative Care (eTG complete), version 5AU/NZTherapeutic Guidelines Limited, 2024 (version 5, December 2024; no later update listed at November 2026)
- Therapeutic Guidelines: Psychotropic (eTG complete)AU/NZTherapeutic Guidelines Limited, February 2025 update
- Grassi L et al. Anxiety and depression in adult cancer patients: ESMO Clinical Practice Guideline. ESMO Open 2023;8:101155European Society for Medical Oncology, 2023 (current at November 2026)
- Andersen BL et al. Management of anxiety and depression in adult survivors of cancer: ASCO guideline update. J Clin Oncol 2023;41:3426-3453American Society of Clinical Oncology, 2023
- Mitchell AJ et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol 2011;12:160-174The Lancet Oncology, 2011
- Chochinov HM et al. 'Are you depressed?' Screening for depression in the terminally ill. Am J Psychiatry 1997;154:674-676American Journal of Psychiatry, 1997
- Lloyd-Williams M et al. Is asking patients in palliative care, 'are you depressed?' appropriate? Prospective study. BMJ 2003;327:372-373BMJ, 2003
- Rodin G et al. Managing Cancer and Living Meaningfully (CALM): a randomized controlled trial of a psychological intervention for patients with advanced cancer. J Clin Oncol 2018;36:2422-2432Journal of Clinical Oncology, 2018
- Chochinov HM et al. Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. Lancet Oncol 2011;12:753-762The Lancet Oncology, 2011
- Endicott J. Measurement of depression in patients with cancer. Cancer 1984;53(10 Suppl):2243-2249Cancer, 1984
- Last updated
- 14 November 2026
What changed
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