Psychiatry in Palliative Care
DEFINITION
- Palliative Care Psychiatry
- A subspecialty focused on mental health needs in serious, life-limiting illness, with goals of symptom relief, psychosocial support, and quality of life.[1],[2]
- The integration of psychiatry into palliative medicine developed primarily in the oncology and advanced illness context in the late 1990s and early 2000s.
- Scope of This Guide
- Applies to patients receiving palliative or end-of-life care who develop psychiatric symptoms in the context of medical illness.
- Palliative care psychiatry differs from palliative psychiatry, which is a subspecialty formed in the early 2010s and focused on applying palliative approaches to treatment-refractory severe mental illness (SMI).[2]
- This guide does not cover providing palliative care for SMI itself.
- Why It Matters
- Palliative Care vs. Hospice
- As per the Center to Advance Palliative Care, palliative care is appropriate at any stage of serious illness alongside disease-directed therapy; hospice is generally for a prognosis of 6 months or less when goals focus on comfort.[5]
- Who Are Experts in This Field?
- While care is delivered in interdisciplinary teams, both palliative care physicians and psychiatrists with specialized palliative training are equipped to provide psychiatric services in palliative care.
- Palliative care physicians typically complete training in internal medicine, while psychiatrists undergo a psychiatric residency. After their initial training, both fields complete a one-year fellowship in palliative medicine.
- If none are available, general psychiatry and internal medicine consults may be helpful
- While care is delivered in interdisciplinary teams, both palliative care physicians and psychiatrists with specialized palliative training are equipped to provide psychiatric services in palliative care.
There's more to see -- the rest of this topic is available only to subscribers.
Last updated: October 2, 2025
Citation
Appel, Deven, et al. "Psychiatry in Palliative Care." Johns Hopkins Psychiatry Guide, The Johns Hopkins University, 2025. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787411/2/Psychiatry_in_Palliative_Care.
Appel D, Wong N, Nestadt P. Psychiatry in Palliative Care. Johns Hopkins Psychiatry Guide. The Johns Hopkins University; 2025. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787411/2/Psychiatry_in_Palliative_Care. Accessed October 8, 2025.
Appel, D., Wong, N., & Nestadt, P. (2025). Psychiatry in Palliative Care. In Johns Hopkins Psychiatry Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787411/2/Psychiatry_in_Palliative_Care
Appel D, Wong N, Nestadt P. Psychiatry in Palliative Care [Internet]. In: Johns Hopkins Psychiatry Guide. The Johns Hopkins University; 2025. [cited 2025 October 08]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787411/2/Psychiatry_in_Palliative_Care.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Psychiatry in Palliative Care
ID - 787411
A1 - Appel,Deven,
AU - Wong,Nicole,M.D.
AU - Nestadt,Paul,M.D.
Y1 - 2025/10/02/
BT - Johns Hopkins Psychiatry Guide
UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787411/2/Psychiatry_in_Palliative_Care
PB - The Johns Hopkins University
DB - Johns Hopkins Guides
DP - Unbound Medicine
ER -