title: Prevalence, course and associations of desire for hastened death in a UK palliative population: a cross-sectional study.
abstract: OBJECTIVE
  To determine the prevalence, severity and remission of desire for hastened death (DHD) in a UK representative sample of patients with advanced disease receiving palliative care and to examine the associations of desire for death.
  
  
  METHODS
  A cross-sectional survey with 4-week follow-up.
  
  
  METHODS
  St Christopher's Hospice, Sydenham, South London, which is a large hospice with homecare, outpatient and inpatient facilities serving five London boroughs.
  
  
  METHODS
  300 patients newly referred to the hospice for palliative care.
  
  
  METHODS
  The Desire for Death Rating Scale (DDRS).
  
  
  RESULTS
  At T1 33/300 (11%) reported DHD and 11/300 (3.7%) had more serious or pervasive DHD. Of those who expressed DHD at T1 and were interviewed at both time points, 35% no longer reported these thoughts. Of those who reported no DHD at T1, 8% reported DHD at T2. The majority of those who had more severe DHD at T1 had a reduced DHD score by T2. Factors associated with T1 DHD included presence of non-malignant disease, depression, more severe physical symptoms, hopelessness and perceived loss of dignity.
  
  
  CONCLUSIONS
  The prevalence of DHD was at the lower end of that seen in previous studies using similar samples. More severe DHD was uncommon and for most part remitted to some extent during the study. The provision of symptom control and timely detection and intervention for depression coupled with a focus on optimising function, instilling hope and preserving dignity are likely to contribute to alleviation of DHD in patients with advanced illness.
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Annabel
authors.initials: A
authors.lastname: Price
authors.forename: William
authors.initials: W
authors.lastname: Lee
authors.forename: Laura
authors.initials: L
authors.lastname: Goodwin
authors.forename: Lauren
authors.initials: L
authors.lastname: Rayner
authors.forename: Rosemary
authors.initials: R
authors.lastname: Humphreys
authors.forename: Penny
authors.initials: P
authors.lastname: Hansford
authors.forename: Nigel
authors.initials: N
authors.lastname: Sykes
authors.forename: Barbara
authors.initials: B
authors.lastname: Monroe
authors.forename: Irene
authors.initials: I
authors.lastname: Higginson
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D065026:Hope; D006738:Hospices; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D028723:Personhood; D013997:Time Factors; D006113:United Kingdom