Keywords

anxiety, depression, hospice, palliative care, posttraumatic stress disorder

 

Authors

  1. Woods, Anne B. MSN, MPH, RN

Abstract

Depression and anxiety are common psychological sequelae in terminal illness. Less well recognized is the possible presence of posttraumatic stress disorder (PTSD), a stress response syndrome that may develop after exposure to trauma, and one that is frequently comorbid with anxiety and depression. With the inclusion of a diagnosis of a life-threatening illness as a criterion stressor for PTSD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 1 there has been widening interest in understanding PTSD in the palliative care population. This article reviews the current knowledge base regarding prevalence of PTSD in patients with potentially life-limiting illnesses, as well as implications for assessment and treatment. The hospice and palliative care concept of caring for the total person involves compassionate recognition of all that the patient brings to the experience of a terminal illness. This includes understanding the influence of past traumatic events and the potential impact this may have on physical, psychological, social, and spiritual aspects of care at the end of life.