September 2014

J Affect Disord. 2014 Sep;166:324-9.

Thoughts of self-harm and depression as prognostic factors in palliative care patients

Lloyd-Williams M, Payne S, Reeve J, Dona RK.

This longitudinal study based in 20 palliative care day units in England, explored whether depression and patient reports of thoughts of self-harm were prognostic factors for survival in 629 patients with advanced cancer. Baseline measures were completed on all these patients, with 494 patients (79%), 405 (64%) and 349 (55%) completing follow-up at 8, 16 and 24 weeks respectively. Higher baseline Patient Health Questionnaire 9 score (indicating moderate to severe depression) correlated to risk of death, with risk of death being 1.3 times higher among patients with moderate or severe depression on this scale. This was also the case for thoughts of self-harm, with risk of death being 1.4 times higher among patients who reported thoughts of self-harm. The baseline score on the Edinburgh Depression Scale did not correlate to risk of death. The authors emphasise the need for psychologically supporting patients at the end of life and in treating depression in this patient group.

Prepared by Jason Boland