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Palliat Support Care. 2013 Dec;11(6):481-9. doi: 10.1017/S1478951512000892. Epub 2013 Mar 19.

Efficacy of dignity therapy for depression and anxiety in terminally ill patients: early results of a randomized controlled trial.

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  • 1Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal.
  • 2Department of Palliative Medicine, Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus, Casa de Saúde da Idanha, Belas, Portugal.
  • 3Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal.
  • 4Center for Evidence Based Medicine, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal.



Dignity therapy (DT) is a short-term psychotherapy developed for patients living with a life-limiting illness. Our aim was to determine the influence of DT on symptoms of depression and anxiety in people with a life-threatening disease with high level of distress, referred to an inpatient palliative care unit.


This was an open-label randomized controlled trial. Sixty terminally ill patients were randomly assigned to one of two groups: intervention group (DT+ standard palliative care [SPC]) or control group (SPC alone). The main outcomes were symptoms of depression and anxiety, measured with the Hospital Anxiety and Depression Scale, assessed at baseline, day 4, day 15, and day 30 of follow-up.


Of the 60 participants, 29 were randomized to DT and 31 to SPC. Baseline characteristics were similar between the two groups. DT was associated with a significant decrease in depressive symptoms at day 4 and day 15 (mean = -4.46, 95% CI, -6.91-2.02, p = 0.001; mean= -3.96, 95% CI, -7.33 to -0.61; p = 0.022, respectively), but not at day 30 (mean = -3.33, 95% CI, -7.32-0.65, p = 0.097). DT was also associated with a significant decrease in anxiety symptoms at each follow-up (mean= -3.96, 95% CI, -6.66 to -1.25, p = 0.005; mean= -6.19, 95% CI, -10.49 to -1.88, p = 0.006; mean = -5.07, 95% CI, -10.22 to -0.09, p = 0.054, respectively).


DT appears to have a short-term beneficial effect on the depression and anxiety symptoms that often accompany patients at the end of their lives. Future research with larger samples compared with other treatments is needed to better understand the potential benefits of this psychotherapy.

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