Priority 23 from the Palliative and end of life care PSP

UNCERTAINTY:  What are the best ways to recognise and treat depression, anxiety and low mood in people who are dying?  What are the pros and cons of different psychotherapeutic interventions, including drug therapies, and when is the best time to provide them?   (JLA PSP Priority 23)
Overall ranking 23
JLA question ID 0026/23
Evidence

Walker J, Sawhney A, Hansen CH, Symeonides S, Martin P, Murrey G, Sharpe M. Treatment of depression in people with lung cancer: a systematic review. Lung Cancer 2013; 79: 46-53 PMID: 23102652

Ongoing trial: Intervention for treating depression among palliative care patients and their families.  http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12610000183088   CanTalk: A trail into the benefits of a talking therapy called CBT for the treatment of depression in adults with advanced cancer.  ISRCTN07622709.
Health Research Classification System category  Generic
Extra information provided by this PSP
Original uncertainty examples Anxiety is a problem on its own but also decreases ability to cope with pain  How does counselling and psychotherapy help?  ~  Which kind of counselling is most effective for people in end of life care?  ~  Should counseling be available to all patients or those who cross a clinical threshold of measured distress?  ~  What's the best way to evaluate effectiveness/outcomes of intervention (especially psychological spiritual care).  ~  Is there a way to get emotional support?  ~  My father sank into depression as the treatment for his cancer stopped working. He was particularly difficult to live with, but there didn't seem to be any support for dealing with his depression, or maybe we didn't know where to turn to. The depression was as difficult to cope with (for all of us) as the cancer was.
Submitted by Professionals x 3      
Outcomes to be measured Patient Satisfaction; health related quality of life; health related cost;quality of care
PSP information
PSP unique ID 0026
PSP name Palliative and end of life care
Total number of uncertainties identified by this PSP. 83  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 November 2014