Patients facing chronic and life-threatening diseases have a high probability of having psychopathology. In palliative care settings, the prevalence of spiritual distress ranges from 10 to 63% and depression from 5 to 50%. Spiritual distress and depression are closely interrelated and share some characteristics regardless of cultural traditions: at the bodily level, symptoms of insomnia, pain, and fatigue; at the emotional level, a sense of guilt, fear, anger, anxiety, loneliness, alienation, lack of confidence, and despair; at the existential level, experiencing a lack of hope, a lack of meaning in life, and a lack of serenity. Nevertheless, although closely interrelated, spiritual distress and depression are distinct diagnoses. There seems to be evidence of having precise clinical indicators and different pharmacological and non-pharmacological therapeutic approaches. 

Teresa Velosa is a family physician consultant and coordinator at Dr Vale Lima Health Unit. She has an MSc in Palliative Care at the Institute of Health Sciences of the Portuguese Catholic University and has collaborated with palliative care teams. She has published and peer-reviewed papers in primary care and palliative care scientific journals.