• Annabel Price, William Lee, Laura Goodwin, Lauren Rayner, Rosemary Humphreys, Penny Hansford, Nigel Sykes, Barbara Monroe, Irene Higginson, and Matthew Hotopf.
• Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
• BMJ Support Palliat Care. 2011 Sep 1;1(2):140-8.

ObjectivesTo 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.DesignA cross-sectional survey with 4-week follow-up.SettingSt Christopher's Hospice, Sydenham, South London, which is a large hospice with homecare, outpatient and inpatient facilities serving five London boroughs.Participants300 patients newly referred to the hospice for palliative care.Main Outcome MeasuresThe Desire for Death Rating Scale (DDRS).ResultsAt 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.ConclusionsThe 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.

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