In 2009, the UK National Institute for Health and Clinical
Excellence (NICE) published recommendations for the management
of depression in people with a chronic health problem.
This guideline covered primary, secondary and tertiary
care but specified that palliative care was outside its remit.11
Depression in palliative care poses particular challenges and
clinicians need clear guidance on improving outcomes at
the end of life. A pragmatic report from the European Association
of Palliative Care (EAPC) in 2001 highlighted the problem
of under-detection and under-treatment of depression in palliative
care. This report called for collaboration between palliative
care and mental health professionals and integration of
clinical experience and scientific evidence in order to establish
best practice.