TY - JOUR
T1 - The desire to hasten death in advanced cancer patients at a Mexican palliative care service
AU - Rodríguez-Mayoral, Oscar
AU - Ascencio-Huertas, Leticia
AU - Verástegui, Emma
AU - Delgado-Guay, Marvin O.
AU - Allende-Pérez, Silvia
N1 - Funding Information:
Conflicts of interest Dr. Marvin Delgado-Guay receives partial support from the National Institutes of Health grant R01CA200867 and has not conflicts of interest. Oscar Rodríguez-Mayoral, Leticia Ascen-cio-Huertas, Emma Verástegui and Silvia Allende-Pérez receive partial support from Consejo Nacional de Ciencia y Tecnología (CONACyT) Sistema Nacional de Investigadores, and declare no potential conflict of interest.
Publisher Copyright:
© Instituto Nacional de Psiquiatria Ramon de la Fuente.
PY - 2019
Y1 - 2019
N2 - Introduction. The desire to hasten death (DHD) might be present in patients with advanced cancer. Multiple distressing physical and psychosocial symptoms may be related to it. There is limited literature about the characteristics of these patients in Mexico. Objective. To describe the prevalence and factors associated with DHD in advanced cancer patients evaluated by a palliative care psychiatrist. Method. We conducted a cross-sectional study, including all patients referred to psychiatric assessment at the Servicio de Cuidados Paliativos of the Instituto Nacional de Cancerologia in Mexico City, from January to December 2016. DHD was defined as the presence of death ideas, suicidal ideation, and/or request for euthanasia or medically assisted suicide. Patients with delirium, dementia, psychosis, or uncontrolled physical symptoms were excluded. Results. Sixty-four patients were included in the study. Most of them were women (59%); the mean age was 49 years old (SD = 16). Of them, 64% met criteria for a major depressive disorder, 64% for generalized anxiety disorder and/or panic disorder, and 11% for substance use disorders. 44% expressed DHD. In a multivariate regression analysis predicting DHD, only one factor emerged: clinical depression (OR = 13.5, p =.002, 95% CI [02.562, 71.726]). Discussion and conclusion. The desire to hasten death is a frequent issue for the patients evaluated at the psychiatric palliative care clinic. Depression and other distressing psychiatric pathologies were associated with DHD. Interdisciplinary interventions are needed to treat DHD. More research is warranted in order to understand the factors associated with the expression of DHD.
AB - Introduction. The desire to hasten death (DHD) might be present in patients with advanced cancer. Multiple distressing physical and psychosocial symptoms may be related to it. There is limited literature about the characteristics of these patients in Mexico. Objective. To describe the prevalence and factors associated with DHD in advanced cancer patients evaluated by a palliative care psychiatrist. Method. We conducted a cross-sectional study, including all patients referred to psychiatric assessment at the Servicio de Cuidados Paliativos of the Instituto Nacional de Cancerologia in Mexico City, from January to December 2016. DHD was defined as the presence of death ideas, suicidal ideation, and/or request for euthanasia or medically assisted suicide. Patients with delirium, dementia, psychosis, or uncontrolled physical symptoms were excluded. Results. Sixty-four patients were included in the study. Most of them were women (59%); the mean age was 49 years old (SD = 16). Of them, 64% met criteria for a major depressive disorder, 64% for generalized anxiety disorder and/or panic disorder, and 11% for substance use disorders. 44% expressed DHD. In a multivariate regression analysis predicting DHD, only one factor emerged: clinical depression (OR = 13.5, p =.002, 95% CI [02.562, 71.726]). Discussion and conclusion. The desire to hasten death is a frequent issue for the patients evaluated at the psychiatric palliative care clinic. Depression and other distressing psychiatric pathologies were associated with DHD. Interdisciplinary interventions are needed to treat DHD. More research is warranted in order to understand the factors associated with the expression of DHD.
KW - Advanced cancer
KW - Depression
KW - Desire to hasten death
KW - Palliative care
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U2 - 10.17711/SM.0185-3325.2019.014
DO - 10.17711/SM.0185-3325.2019.014
M3 - Article
AN - SCOPUS:85081668328
SN - 0185-3325
VL - 42
SP - 103
EP - 109
JO - Salud Mental
JF - Salud Mental
IS - 3
ER -