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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2019, Number 3

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Salud Mental 2019; 42 (3)

The desire to hasten death in advanced cancer patients at a Mexican palliative care service

Rodríguez-Mayoral O, Ascencio-Huertas L, Verástegui E, Delgado-Guay MO, Allende-Pérez S

Language: English
References: 34
Page: 103-109
PDF size: 376.89 Kb.


ABSTRACT

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 México. 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 Cancerología 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.


REFERENCES

  1. Allende-Pérez, S. & Verástegui-Avilés, E. (2013). La Medicina paliativa y el paciente con cáncer. Gaceta Mexicana de Oncología, 12(4), 211-212.

  2. American Psychiatric Association. (2014). Manual diagnóstico y estadístico de los trastornos mentales - DSM 5. Quinta edición. Buenos Aires: Médica Panamericana.

  3. Armstrong, C. (2011). APA releases guideline on treatment of patients with major depressive disorder. American Family Physician, 83(10), 1219-1227.

  4. Arrieta, Ó., Angulo, L. P., Núñez-Valencia, C., Dorantes-Gallareta, Y., Macedo, E. O., Martínez-López, D., … & Oñate-Ocaña, L. F. (2013). Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Annals of Surgical Oncology, 20(6), 1941-1948. doi: 10.1245/s10434-012-2793-5

  5. Balaguer, A., Monforte-Royo, C., Porta-Sales, J., Alonso-Babarro, A., Altisent, R., Aradilla-Herrero, A., … & Voltz, R. (2016). An international consensus definition of the wish to hasten death and its related factors. PloS One, 11(1):e0146184. doi: 10.1371/journal.pone.0146184

  6. Ballard, E. D., Pao, M., Henderson, D., Lee, L. M., Bostwick, J. M., & Rosenstein, D. L. (2008). Suicide in the medical setting. Joint Commission Journal on Quality and Patient Safety, 34(8), 474-481.

  7. Bellido-Pérez, M., Monforte-Royo, C., Tomás-Sábado, J., Porta-Sales, J., & Balaguer, A. (2017). Assessment of the wish to hasten death in patients with advanced disease: A systematic review of measurement instruments. Palliative Medicine, 31(6), 510-525. doi: 10.1177/0269216316669867

  8. Breitbart, W., Rosenfeld, B., Pessin, H., Kaim, M., Funesti-Esch, J., Galietta, M., … & Brescia, R. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA, 284(22), 2907-2911. doi: 10.1001/ jama.284.22.2907

  9. Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6-9.

  10. Chao, Y.-S., Boivin, A., Marcoux, I., Garnon, G., Mays, N., Lehoux, P., … & de Langavant, G. (2016). International changes in end-of-life practices over time: a systematic review. BMC Health Services Research, 16(1):539. doi: 10.1186/ s12913-016-1749-z

  11. Chochinov, H. M., Wilson, K. G., Enns, M., Mowchun, N., Lander, S., Levitt, M., & Clinch, J. J. (1995). Desire for death in the terminally ill. The American Journal of Psychiatry, 152(8), 1185-1191. doi: 10.1176/ajp.152.8.1185

  12. Chochinov, H. M. (2016). Physician-Assisted death in Canada. JAMA, 315(3), 253- 254. doi: 10.1001/jama.2015.17435

  13. Delgado-Guay, M. O., Hui, D., Parsons, H. A., Govan, K., De la Cruz, M., Thorney, S., & Bruera, E. (2011). Spirituality, religiosity, and spiritual pain in advanced cancer patients. Journal of Pain and Symptom Management, 41(6), 986-994. doi: 10.1016/j.jpainsymman.2010.09.017

  14. Houmann, L. J., Chochinov, H. M., Kristjanson, L. J., Petersen, M. A., & Groenvold, M. (2014). A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care. Palliative Medicine, 28(5), 448-458. doi: 10.1177/0269216313514883

  15. Julião, M., Barbosa, A., Oliveira, F., & Nunes, B. (2013). Prevalence and factors associated with desire for death in patients with advanced disease: Results from a Portuguese cross-sectional study. Psychosomatics, 54(5), 451-457. doi: 10.1016/j.psym.2013.01.006

  16. Kelly, B., Burnett, P., Pelusi, D., Badger, S., Varghese, F., & Robertson, M. (2003). Factors associated with the wish to hasten death: A study of patients with terminal illness. Psychological Medicine, 33(1), 75-81. doi: 10.1017/ S0033291702006827

  17. Kremeike, K., Galushko, M., Frerich, G., Romotzky, V., Hamacher, S., Rodin, G., … & Voltz, R. (2018). The DEsire to DIe in Palliative care: Optimization of Management (DEDIPOM) – a study protocol. BMC Palliative Care, 17(1):30. doi: 10.1186/s12904-018-0279-3

  18. Kumar, V., Chaudhary, N., Soni, P., & Jha, P. (2017). Suicide rates in cancer patients in the current era in united states. American Journal of Psychiatry - Residents’ Journal, 12(1), 11-14. doi: 10.1176/appi.ajp-rj.2017.120104

  19. Madeira, N., Albuquerque, E., Santos, T., Mendes, A., & Roque, M. (2011). Death ideation in cancer patients: Contributing factors. Journal of Psychosocial Oncology, 29(6), 636-642. doi: 10.1080/07347332.2011.615381

  20. Mehta, R. D. & Roth, A. J. (2015). Psychiatric considerations in the oncology setting: Psychiatric considerations in the oncology setting. CA: A Cancer Journal for Clinicians, 65(4), 299-314. doi: 10.3322/caac.21285

  21. Mercadante, S. & Bruera, E. (2016). Opioid switching in cancer pain: From the beginning to nowadays. Critical Reviews in Oncology/Hematology, 99, 241- 248. doi: 10.1016/j.critrevonc.2015.12.011

  22. Morita, T., Tsunoda, J., Inoue, S., & Chihara, S. (1999). The Palliative Prognostic Index: A scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 7(3), 128-133.

  23. Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., … & Carbone, P. P. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5(6), 649-656.

  24. Polanski, J., Jankowska-Polanska, B., Rosinczuk, J., Chabowski, M., & Szymanska- Chabowska, A. (2016). Quality of life of patients with lung cancer. OncoTargets and Therapy, 9, 1023-1028. doi: 10.2147/OTT.S100685

  25. Quill, T. E., Back, A. L., & Block, S. D. (2016). Responding to patients requesting physician-assisted death: Physician involvement at the very end of life. JAMA, 315(3), 245-246. doi: 10.1001/jama.2015.16210

  26. Rosenfeld, B., Breitbart, W., Galietta, M., Kaim, M., Funesti-Esch, J., Pessin, H., … & Brescia, R. (2000). The schedule of attitudes toward hastened death: Measuring desire for death in terminally ill cancer patients. Cancer, 88(12), 2868-2875. doi: 10.1002/1097-0142(20000615)88:12<2868::aid-cncr30>3.0.co;2-k

  27. Saxena, S., Krug, E. G., Chestnov, O., & World Health Organization (Eds.). (2014). Preventing suicide: A global imperative. Geneva: World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng. pdf?sequence=1&isAllowed=y.

  28. Strasser-Weippl, K., Chavarri-Guerra, Y., Villarreal-Garza, C., Bychkovsky, B. L., Debiasi, M., Liedke, P. E. R., … & Goss, P. E. (2015). Progress and remaining challenges for cancer control in Latin America and the Caribbean. The Lancet. Oncology, 16(14), 1405-1438. doi: 10.1016/S1470-2045(15)00218-1

  29. Vehling, S., Kissane, D. W., Lo, C., Glaesmer, H., Hartung, T. J., Rodin, G., & Mehnert, A. (2017). The association of demoralization with mental disorders and suicidal ideation in patients with cancer: Demoralization and Mental Disorders. Cancer, 123(17), 3394-3401. doi: 10.1002/cncr.30749

  30. Wagner, F. A., González-Forteza, C., Sánchez-García, S., García-Peña, C., & Gallo, J. J. (2012). Enfocando la depresión como problema de salud pública en México. Salud Mental, 35(1), 3-11.

  31. Wilson, K. G., Chochinov, H. M., Skirko, M. G., Allard, P., Chary, S., Gagnon, P. R., … & Clinch, J. J. (2007). Depression and anxiety disorders in palliative cancer care. Journal of Pain and Symptom Management, 33(2), 118-129. doi: 10.1016/j.jpainsymman.2006.07.016

  32. Wilson, K. G., Dalgleish, T. L., Chochinov, H. M., Chary, S., Gagnon, P. R., Macmillan, K., … & Fainsinger, R. L. (2016). Mental disorders and the desire for death in patients receiving palliative care for cancer. BMJ Supportive & Palliative Care, 6(2), 170-177. doi: 10.1136/bmjspcare-2013-000604

  33. Yates, J. W., Chalmer, B., & McKegney, F. P. (1980). Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer, 45(8), 2220-2224. doi: 10.1002/1097-0142(19800415)45:8<2220::aidcncr2820450835> 3.0.co;2-q

  34. Zhong, B.-L., Li, S.-H., Lv, S.-Y., Tian, S.-L., Liu, Z.-D., Li, X.-B., … & Zhuo, C.-J. (2017). Suicidal ideation among Chinese cancer inpatients of general hospitals: prevalence and correlates. Oncotarget, 8(15), 25141-25150. doi: 10.18632/ oncotarget.15350




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