William Breitbart

..This article provides medical practitioners with an overview of the issues and symptoms common in terminal illness, to help them work most effectively with their mental health colleagues...

..We developed Individual Meaning-Centered Psychotherapy (IMCP) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer...

..This article presents evidence-based recommendations based on the results of pharmacologic and nonpharmacologic studies of the treatment and prevention of delirium...

..The appropriate and timely use of psychotropic adjuvant analgesic drugs represents an opportunity for active psychiatric contribution to the multidisciplinary management of cancer and AIDS pain...

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..We further explore spiritual and existential themes through this meaning-oriented approach that encourages dying patients to find meaning and purpose in living until their death...

..Despite the development of multi-drug regimens for HIV, palliative care and quality-of-life issues in patients with advanced AIDS remain important areas of clinical investigation...

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..However, studies are currently limited. Randomized, placebo-controlled trials with specific agents are needed to further assess the efficacy and tolerability of psychotropic medications in the treatment of cancer-related fatigue...

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..Finally, principles of pain management, with particular emphasis on controlling pain in HIV-infected patients with a history of substance abuse, are outlined...

..Understanding why some terminally ill patients desire a hastened death has become an important issue in palliative care and the debate regarding legalization of assisted suicide...

..Preliminary studies on the treatment of fatigue from the cancer and multiple sclerosis literature suggest that psychostimulants may be effective in reducing fatigue...

..Finally, a review of existing psychotherapeutic interventions for spiritual suffering are reviewed and a novel meaning-centered group psychotherapy for advanced cancer patients is described...

..5). Olanzapine appears to be a clinically efficacious and safe drug for the treatment of the symptoms of delirium in the hospitalized medically ill...

..Delirium is also a highly distressing experience for spouses/caregivers and nurses who are caring for delirious patients. Prompt recognition and treatment of delirium is critically important to reduce suffering and distress...

..Finally, principles of pain management, with particular emphasis on controlling pain in HIV-infected patients with a history of substance abuse, are outlined...

..Anxiety in terminal cancer is linked to diminished quality of life, yet overall it is poorly understood with regard to prevalence and relationship to other aspects of psychological distress...

..This study aims to develop a theoretical framework of the relationship among religiosity, spirituality, and depression, potentially explaining the often mixed and inconsistent associations between religiosity and depression...

..This study examined grief and mental health service use among 86 bereaved caregivers of advanced cancer patients...

..This is particularly true when death and dying are the focus of research. Therefore, it is important to understand the specific ways psychosocial research could potentially harm or be helpful to participants...

..Current research suggests that older cancer patients report less distress than younger cancer patients. However, this research has generally not teased apart the differences among general distress, anxiety, and depression...

..Fatigue is a highly prevalent and clinically significant symptom of advanced prostate cancer. To date, however, there are no published controlled trials of interventions for fatigue in men with prostate cancer...

..Risk factors for the development of depression have been identified. Pharmacologic and nonpharmacologic treatments for depression are often effective even in patients with advanced cancer...

..The purpose of this study was to examine the efficacy and safety of aripiprazole in the treatment of delirium in hospitalized cancer patients, and to examine differential responses based on delirium subtypes...

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..Randomized, placebo-controlled trials with specific agents are needed to further assess the efficacy and tolerability of psychotropic medications in CRF treatment...

..In order to investigate the treatment characteristics of patients with delirium superimposed on dementia in contrast to delirium in the absence of dementia we performed a secondary analysis of our delirium database...

..Implications for clinical interventions and palliative-care practice are discussed...

..The objective of this study was to examine the construct of hopelessness in patients with advanced AIDS by examining the structure of the Beck Hopelessness Scale in this specific population...

..To compare the efficacy and tolerability of aripiprazole and haloperidol in the amelioration of distressing symptoms of delirium and its motoric subtypes...

..To determine whether the prevalence of mental disorders and related factors increase as advanced cancer patients get closer to death...

..We conclude that olanzapine may be useful in the treatment of patients with uncontrolled cancer pain associated with cognitive impairment or anxiety. Further studies to evaluate possible analgesic effect of olanzapine are needed...

..Future studies focusing on the relationship between immune functioning and depression must be particularly vigilant regarding methodological issues...

..Aggressive treatment of cognitive symptoms in the terminally ill is necessary in order to disentangle the various factors that may drive end-of-life treatment decisions...

..To review the literature on depression in cancer patients with a particular focus on depression assessment and barriers to mental health treatment in older cancer patients...

..To review the literature on depression in cancer patients with a particular focus on depression assessment and barriers to mental health treatment in older cancer patients...

..However, level of disturbance in consciousness (arousal and awareness) and impairments in multiple cognitive domains are significantly more severe in patients with delirium superimposed on dementia...

..Positive interpersonal relationships enhanced hope, and uncontrolled physical pain increased vulnerability to hopelessness...

..2002a, 2002b). In this article, we present an update of the use of antipsychotics in management of delirium based on the available literature and our own clinical experience...

..To review the existing literature of atypical antipsychotics in the treatment of delirium and make recommendations regarding their use in the treatment of delirium...

..This scale consists of three subscales that measure general prostate cancer anxiety, anxiety related to prostate specific antigen (PSA) levels in particular, and fear of recurrence...

..Our findings have important implications for palliative care practice. Controlled research assessing the effect of spirituality-based interventions is needed to establish what methods can help engender a sense of peace and meaning...

..The authors concluded that spirituality has a much more powerful effect on psychological functioning than beliefs held about an afterlife. Treatment implications are discussed...

..Authors discuss the implications of these findings for palliative care practice and the assisted-suicide debate...

..Frankl's existential therapeutic approach, called logotherapy, serves as the underlying theoretical framework to this intervention...

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..Strategies to preemptively screen for depression in the routine assessment of patients with cancer pain may be important to address DHD...

..Multiple barriers contribute to why cancer patients do not comment about fatigue but may be overcome if physicians screen and assess for this symptom...

..novel and innovative psychotherapy intervention for patients with advanced cancer, incorporating spiritual (meaning-centered) elements, which holds great promise in the treatment of spiritual suffering at the end-of-life ..

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..This study is expected to provide a direct evaluation of desire for death in terminally ill cancer patients, and to ascertain whether a pharmacological treatment for depression influences desire for death. ..

..Larger, randomized controlled trials of Meaning-Centered Group Psychotherapy will be conducted in the future utilizing the insights learned from this pilot intervention study. ..

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