Hughes Daniel, Yardley Sarah, Greenfield Philippa, Rolph Martin
Camden and Islington NHS Foundation Trust, UK.
University College London, UK.
BJPsych Bull. 2023 Feb;47(1):43-48. doi: 10.1192/bjb.2021.124.
The concurrent assessment and treatment of mental health disorders and palliative illnesses is complex. Affective disorders are more prevalent in people who need palliative care. Identifying the most suitable place of care and multi-professional multidisciplinary teams to provide support can be challenging and bewildering for professionals and patients. Mental health clinicians may be left with a sense of therapeutic nihilism, while palliative care teams can feel limited by the mental health resources available for treating those living with significant physical and mental health needs. We discuss the fictional case of a gentleman with metastatic bowel cancer who has developed symptoms of depressive disorder and identify how taking a pragmatic patient-centred approach can offer a route through potential dilemmas when seeking to provide individualised care based on needs. We used lay person experience alongside our own experiences of novel mechanisms for cross-specialty working in order to direct psychiatric trainees' approaches to such cases.
对心理健康障碍和姑息性疾病进行同步评估和治疗是复杂的。情感障碍在需要姑息治疗的人群中更为普遍。确定最合适的护理场所和多专业多学科团队来提供支持，对专业人员和患者来说可能具有挑战性且令人困惑。心理健康临床医生可能会产生治疗虚无主义的感觉，而姑息治疗团队可能会觉得用于治疗那些有重大身心健康需求者的心理健康资源有限。我们讨论了一位患有转移性肠癌且出现抑郁症症状的先生的虚构案例，并确定在寻求根据需求提供个性化护理时，采取务实的以患者为中心的方法如何能够为应对潜在困境提供一条途径。我们结合外行的经验以及我们自己在跨专业合作新机制方面的经验，来指导精神科实习医生处理此类病例的方法。
