|
| | |
|
Am J Psychiatry 1994; 151:1631-1636
Copyright © 1994 by American Psychiatric Association
The effect of depression treatment on elderly patients' preferences for life-sustaining medical therapy
L Ganzini, MA Lee, RT Heintz, JD Bloom and DS Fenn
Psychiatry Service, Portland VA Medical Center, OR 97207.
OBJECTIVE: This study was undertaken 1) to test the hypothesis that
remission of depression results in an increase in desire for life-
sustaining medical therapy and 2) to characterize patients whose desire for
life-sustaining treatment increases substantially following depression
therapy. METHOD: Elderly patients, suffering from major depression, were
interviewed on admission to a psychiatric inpatient unit and at discharge
about their desire for specific medical therapies in their current state of
health and in two hypothetical scenarios of medical illness. A psychiatrist
rated the impact of depressive thinking on the subject's response to these
questions. Forty-three subjects completed the study, and 24 were in
remission from depression at the time of discharge. RESULTS: In the
majority of patients, remission of depression did not result in an increase
in desire for life-sustaining medical therapy. However, a clinically
evident increase in desire for life-sustaining medical therapies followed
treatment of depression in subjects (N = 11 [26%]) who had been initially
rated as more severely depressed, more hopeless, and more likely to
overestimate the risks and to underestimate the benefits of treatment.
CONCLUSIONS: In major depression of mild to moderate severity, a patient's
desire to forgo life-sustaining medical treatment is unlikely to be altered
by depression treatment. On the other hand, severely depressed patients,
particularly those who are hopeless, overestimate the risks of treatment,
or underestimate the benefits of treatment, should be encouraged to defer
advance treatment directives. In these patients decisions about
life-sustaining therapy should be discouraged until after treatment of the
depression.
This article has been cited by other articles:
|
|
|
|
 
J. M. Lyness
End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Focus,
January 1, 2007;
5(4):
459 - 471.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Guentner, L. A. Hoffman, M. B. Happ, Y. Kim, A. D. Dabbs, A. B. Mendelsohn, and L. Chelluri
Preferences for Mechanical Ventilation Among Survivors of Prolonged Mechanical Ventilation and Tracheostomy
Am. J. Crit. Care.,
January 1, 2006;
15(1):
65 - 77.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. D. Block and for the American College of Physicians-American So
Assessing and Managing Depression in the Terminally Ill Patient
Focus,
April 1, 2005;
3(2):
310 - 319.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Lyness
End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Focus,
April 1, 2005;
3(2):
341 - 353.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. I. Papakostas, T. Petersen, J. Pava, E. Masson, J. J. Worthington III, J. E. Alpert, M. Fava, and A. A. Nierenberg
Hopelessness and Suicidal Ideation in Outpatients With Treatment-Resistant Depression: Prevalence and Impact on Treatment Outcome
Focus,
January 1, 2005;
3(1):
140 - 145.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. D. Stapleton, E. L. Nielsen, R. A. Engelberg, D. L. Patrick, and J. R. Curtis
Association of Depression and Life-Sustaining Treatment Preferences in Patients With COPD
Chest,
January 1, 2005;
127(1):
328 - 334.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Lyness
End-of-Life Care: Issues Relevant to the Geriatric Psychiatrist
Am J Geriatr Psychiatry,
October 1, 2004;
12(5):
457 - 472.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. B. Greenberg
Barriers to the Treatment of Depression in Cancer Patients
J Natl Cancer Inst Monographs,
July 1, 2004;
2004(32):
127 - 135.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Ganzini, E. R. Goy, L. L. Miller, T. A. Harvath, A. Jackson, and M. A. Delorit
Nurses' Experiences with Hospice Patients Who Refuse Food and Fluids to Hasten Death
N. Engl. J. Med.,
July 24, 2003;
349(4):
359 - 365.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C.-F. Liu, S. C. Hedrick, E. F. Chaney, P. Heagerty, B. Felker, N. Hasenberg, S. Fihn, and W. Katon
Cost-Effectiveness of Collaborative Care for Depression in a Primary Care Veteran Population
Psychiatr Serv,
May 1, 2003;
54(5):
698 - 704.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. WERTH Jr.
Legal and Ethical Considerations for Mental Health Professionals Related to End-of-life Care and Decision Making
American Behavioral Scientist,
November 1, 2002;
46(3):
373 - 388.
[Abstract]
[PDF]
|
|
|
|
|
|
|
L. M. Cohen, S. K. Dobscha, K. C. Hails, P. S. Pekow, and H. M. Chochinov
Depression and Suicidal Ideation in Patients Who Discontinue the Life-Support Treatment of Dialysis
Psychosom Med,
November 1, 2002;
64(6):
889 - 896.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. E. Ness
Discussing Treatment Options and Risks With Medical Patients Who Have Psychiatric Problems
Arch Intern Med,
October 14, 2002;
162(18):
2037 - 2044.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. T. Karlawish and D. Casarett
Addressing the Ethical Challenges of Clinical Trials That Involve Patients with Dementia
J Geriatr Psychiatry Neurol,
December 1, 2001;
14(4):
222 - 228.
[Abstract]
[PDF]
|
|
|
|
|
|
|
F. Pochard, E. Azoulay, M. Grassin, E. J. Emanuel, and L. L. Emanuel
Assessing Requests for Euthanasia From Terminally Ill Patients
JAMA,
February 14, 2001;
285(6):
734 - 735.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. G. Wilson, J. F. Scott, I. D. Graham, J. F. Kozak, S. Chater, R. A. Viola, B. J. de Faye, L. A. Weaver, and D. Curran
Attitudes of Terminally Ill Patients Toward Euthanasia and Physician-Assisted Suicide
Arch Intern Med,
September 11, 2000;
160(16):
2454 - 2460.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. D. Block and for the ACP-ASIM End-of-Life Care Consensus Panel
Assessing and Managing Depression in the Terminally Ill Patient
Ann Intern Med,
February 1, 2000;
132(3):
209 - 218.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Bostwick and B. J. Masterson
Psychopharmacological Treatment of Delirium to Restore Mental Capacity
Psychosomatics,
April 1, 1998;
39(2):
112 - 117.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
P. R. Muskin
The Request to Die: Role for a Psychodynamic Perspective on Physician-Assisted Suicide
JAMA,
January 28, 1998;
279(4):
323 - 328.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Ganzini and M. A. Lee
Psychiatry and Assisted Suicide in the United States
N. Engl. J. Med.,
June 19, 1997;
336(25):
1824 - 1826.
[Full Text]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1994
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
