Contemporary and Innovative Practice in Palliative Care by E. Chang, et. al.

By E. Chang, et. al.

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Depressive and anxiety symptoms can reflect the existence of a psychiatric pathology. , 2002). , 2008; Breitbart, 1995). This low level of detection may be related to the as-yet-incomplete incorporation of mental health professionals into medical teams, as well as to insufficient medical training in the detection, assessment, and treatment of psychiatric disorders. The Hospital Anxiety and Depression Scale (HADS) is one of the more commonly used tools to screen for anxiety and depression in hospitalized patients.

We believe the different results may be due to cultural differences between Chilean and Dutch patients, as well as to national differences in Karnofsky score (average 65 and 50 in the Chilean and Dutch population, respectively). It should also be noted that the previous study included fewer subjects than did the current one, potentially lending less validity to their data. The usefulness of the ESAS as a screening test in anxiety and depression is derived mainly from its sensitivity and negative predictive value.

From these results, we conclude that in patients with anxiety and depressive symptoms there is a strong association between the frequency and intensity of physical symptoms and the presence of psychological symptoms. Additionally our results suggests that the ESAS can be a useful screening tool to improve the clinical detection of anxious or depressive syndromes in terminal patients. We found that psychological disturbance was associated with significantly more frequent and intense physical symptoms.

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