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Delirium and Depression in Advanced Cancer: Forensic Aspects

Singh K.K. , Singh K.K. , Chandurkar Milind B , Kumawat Kamlesh , C. Jayanthi , Kolse Ajay , Behere B Prakash

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Indian Journal of Forensic Medicine and Pathology 3(3):p 103-107, July - September 2010. | DOI:

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Abstract

Background: Delirium and depression in people with cancer is important because of its relatively high prevalence, poor prognosis if undetected and the impact on the quality of life. Considering its importance, we have made this review article to know surprisingly little about the frequency of poor outcomes, or the factors which might predict poor outcomes. Often misdiagnosed by clinicians as a psychiatric disorder and the underlying cause is not focused on. The experience of delirium causes distress to patient and their care givers and has obvious implications for quality of life for both. Under diagnosis of delirium have serious implications as delirium may be a marker of potentially reversible pathology. Apart from being a cause of poor outcome, the delirium state may lead to difficulties with treatment, rehabilitation and interfere with activities of daily living. The presence of major depressive disorder should result in an automatic finding of incompetence. Psychiatrists with ethical objections to assisted suicide advocate a higher threshold for competence and more extensive review of a decision. The ethical views of psychiatrists may influence their clinical opinions regarding patient competence to consent to assisted suicide. The extensive evaluation of these terminally ill cancer patients is thus recommended by forensic psychiatrists.

Key words: Psychiatric disorder, Cancer patient, Forensic psychhiatry, Delirium & depression

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