Article Text

The assessment of mental state in advanced stage of disease
  1. Liz Bryan and
  2. Sharon Scott, Lecturer/Practitioner
  1. Liz Bryan, Lecturer/Practitioner, St Christopher’s Hospice and King’s College London, member of the Advancing Practice Team, St Christopher’s Hospice; Sharon Scott, Clinical Nurse Specialist, Home Care Team, St Christopher’s Hospice, London. Email: l.bryan{at}


There have been many advances in the palliation and management of symptoms in advanced disease. However, according to the literature, the assessment and management of psychological and psychiatric disorders, such as depression, anxiety and delirium, are still poor. These disorders, if left untreated, can have a detrimental effect on the patient’s quality of life. They interfere with the patient’s ability to function socially and emotionally and cause immense distress, adding to the overall symptom burden. It is therefore important that health professionals have the skills and knowledge to recognise signs and symptoms of psychiatric disorders, in order that they can plan appropriate care and support for patients and families. This article describes a structured approach to mental state examination, including the use of validated diagnostic screening tools. It discusses the benefits of this type of assessment process and how it can help facilitate a better informed management plan. Conflicts of interest: none

  • Advanced practice
  • Depression
  • Mental state examination
  • Psychological distress
  • Quality of life

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