Psychiatric symptoms in terminal phase

Constantin Bogdan, MD, PhD, gerontology and geriatrics, internal medicine, associate professor, chairman of the Bioethics Romanian Committee of UNESCO

Address for correspondence: c_bogdan34@yahoo.com

Abstract

Terminally psychiatric symptoms are generally less controlled than the physical ones, especially in the elderly terminal patients. In elderly, it is not easy to distinguish such symptoms being caused by age or by a psychiatric disorder, which may be related to the terminal period of existence. Sometimes, these symptoms overlap with pre-existing mental disorder deepening them in the terminal period.

In addition, physicians providing palliative care can be less familiar with psychiatric and psychogeriatric symptoms and with their specific medication.

The presence of pain, depression, psychosocial problems and age-related symptoms are common in elderly. Depression in old age is often difficult to distinguish from depression of the terminal phase. In addition to depression agitation may occur with varying degrees of intensity, from anxiety to psychomotor agitation with verbal manifestations, soliloquies, uncontrolled movements and gestures. Also anxiety and panic may be present.

Many elderly people with severe illness are afraid for a worsening and they fear loss of control of their own freedom and integrity.

Keywords: terminal phase, psychiatric symptoms, agitation, anxiety, panic, delirium, pain, depression, anxiety, soliloquies, uncontrolled movements and gestures

(Full text in Romanian)

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