A palliative care approach in psychiatry: clinical implications

Traditionally, palliative care has focused on patients suffering from life-threatening somatic diseases such as cancer or progressive neurological disorders. In contrast, despite the often chronic, severely disabling, and potentially life-threatening nature of psychiatric disorders, there are neithe...

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Bibliographic Details
Published in:BMC medical ethics 2020-04, Vol.21 (1), p.29-29, Article 29
Main Authors: Strand, Mattias, Sjöstrand, Manne, Lindblad, Anna
Format: Article
Language:English
Subjects:
Anorexia
Anorexia nervosa
Bioethics
Borderline personality disorder
Care and treatment
Case management
Clinical practice guidelines
Debate
Eating disorders
Medicin och hälsovetenskap
Mental disorders
Mortality
Nervous system diseases
Palliative care
Patients
Psychiatry
Quality of life
Recovery
Recovery (Medical)
Schizophrenia
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Summary:Traditionally, palliative care has focused on patients suffering from life-threatening somatic diseases such as cancer or progressive neurological disorders. In contrast, despite the often chronic, severely disabling, and potentially life-threatening nature of psychiatric disorders, there are neither palliative care units nor clinical guidelines on palliative measures for patients in psychiatry. This paper contributes to the growing literature on a palliative approach in psychiatry and is based on the assumption that a change of perspective from a curative to a palliative approach could help promote patient-centeredness and increase quality of life for severely ill patients in psychiatry as well as in somatic medicine. To exemplify this, we offer three different clinical scenarios: severe and enduring anorexia nervosa, treatment-refractory schizophrenia, and chronic suicidality and persistent self-injury in borderline personality disorder. We emphasize that many typical interventions for treatment-refractory psychiatric disorders may indeed be of a palliative nature. Furthermore, introducing traditional features of palliative care, e.g. so-called goals of care conversations, could aid even further in ensuring that caregivers, patients, and families agree on which treatment goals are to be prioritized in order to optimize quality of life in spite of severe, persistent mental disorder.
ISSN:1472-6939
1472-6939
DOI:10.1186/s12910-020-00472-8