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Prevalence, Severity, and Correlates of Depressive Symptoms on Admission to Inpatient Hospice

Depression is underdiagnosed and undertreated in palliative care. Although the etiology of depression at end of life is complex, debate typically focuses on preparatory grief versus depression. Recent evidence suggests that depression is part of a symptom cluster with pain and fatigue. This cross-sectional, descriptive, correlational study investigated the prevalence, severity, and correlates of depressive symptoms on admission to inpatient hospice. Of the 109 patients, 68.8% reported levels of depressive symptoms consistent with major depressive disorder, but only 11.5% of patients were treated with antidepressants prior to admission. Significant correlations were found for depressive symptoms with impaired overall well-being, pain, drowsiness, decreased activity, anxiety, and global symptom distress score. Impaired overall well-being and global symptom distress score accounted for the majority of the variance in depressive symptom ratings. Utilizing a concept of symptom clusters may facilitate increased diagnosis and treatment for depressive symptoms at end of life.