Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
J Palliat Med. 2024 Nov;27(11):1531-1540. doi: 10.1089/jpm.2024.0131. Epub 2024 May 9.
Addressing the psychiatric aspects of serious illness in palliative care (PC) is crucial to both care delivery and outcomes. Psychiatric comorbidities are common among patients with PC needs and can significantly impact their total burden of symptomatic distress, overall quality of life, functional independence, and healthcare utilization. Yet, these aspects of care are often deferred to mental health consultant teams in the context of busy PC services and often limited human resources. To provide comprehensive and person-centered care, PC clinicians must understand the interplay between medical conditions and psychiatric presentations within a biopsychosocial framework to respond empathically, efficiently, and effectively. This article is the first of a two-part series developed in collaboration with a group of psychiatric-palliative care specialists. This article explores ten common physical manifestations of psychiatric illness and treatment among patients facing serious illnesses. The second article will provide pragmatic tips PC clinicians should know about the psychiatric manifestations of nonpsychiatric serious illness and treatment. Combined, these two articles support a holistic approach that PC clinicians can use to prioritize and integrate both mental and emotional well-being throughout the continuum of serious illness.
在姑息治疗（PC）中解决严重疾病的精神科方面对于护理提供和结果至关重要。精神科合并症在有 PC 需求的患者中很常见，会严重影响他们的症状困扰总负担、整体生活质量、功能独立性和医疗保健利用。然而，在 PC 服务繁忙且人力资源有限的情况下，这些护理方面通常会转介给心理健康顾问团队。为了提供全面和以患者为中心的护理，PC 临床医生必须在生物心理社会框架内理解医疗状况和精神科表现之间的相互作用，以同理心、高效和有效地做出反应。本文是与一组精神科姑息治疗专家合作开发的两部分系列文章的第一部分。本文探讨了面临严重疾病的患者中十种常见的精神疾病的躯体表现和治疗。第二篇文章将提供 PC 临床医生应该了解的非精神科严重疾病和治疗的精神科表现的实用技巧。这两篇文章结合起来支持了一种整体方法，PC 临床医生可以使用该方法在严重疾病的整个连续体中优先考虑和整合心理和情感健康。
