Periyakoil Vyjeyanthi S, Hallenbeck James
Stanford University School of Medicine, California, USA.
Am Fam Physician. 2002 Mar 1;65(5):883-90.
Grief and depression present similarly in patients who are dying. Conventional symptoms (e.g., frequent crying, weight loss, thoughts of death) used to assess for depression in these patients may be imprecise because these symptoms are also present in preparatory grief and as a part of the normal dying process. Preparatory grief is experienced by virtually all patients who are dying and can be facilitated with psychosocial support and counseling. Ongoing pharmacotherapy is generally not beneficial and may even be harmful to patients who are grieving. Evidence of disturbed self-esteem, hopelessness, an active desire to die and ruminative thoughts about death and suicide are indicative of depression in patients who are dying. Physicians should have a low threshold for treating depression in patients nearing the end of life because depression is associated with tremendous suffering and poor quality of life.
悲伤和抑郁在濒死患者身上表现相似。用于评估这些患者抑郁状况的传统症状（如频繁哭泣、体重减轻、死亡念头）可能并不准确，因为这些症状在预备性悲伤以及正常濒死过程中也会出现。几乎所有濒死患者都会经历预备性悲伤，心理社会支持和咨询有助于缓解这种悲伤。持续进行药物治疗通常并无益处，甚至可能对处于悲伤中的患者有害。自尊紊乱、绝望、主动求死的愿望以及反复思考死亡和自杀等迹象表明濒死患者存在抑郁。医生对于治疗临终患者的抑郁应保持较低的门槛，因为抑郁会带来巨大痛苦并导致生活质量低下。
