Assessing Demoralization and Depression in the Setting of Medical Disease
J Clin Psychiatry 2005;66(3):391-394
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: The aim of this study was to
assess the presence of demoralization and major depression in the
setting of medical disease.
Method: 807 consecutive outpatients recruited
from different medical settings (gastroenterology, cardiology,
endocrinology, and oncology) were assessed according to DSM-IV
criteria and Diagnostic Criteria for Psychosomatic Research,
using semistructured research interviews.
Results: Demoralization was identified in 245
patients (30.4%), while major depression was present in 135
patients (16.7%). Even though there was a considerable overlap
between the 2 diagnoses, 59 patients (43.7%) with major
depression were not classified as demoralized, and 169 patients
(69.0%) with demoralization did not satisfy the criteria for
Conclusions: The findings suggest a high
prevalence of demoralization in the medically ill and the
feasibility of a differentiation between demoralization and
depression. Further research may determine whether
demoralization, alone or in association with major depression,
entails prognostic and clinical implications.