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Depression and demoralization as distinct syndromes: Preliminary data from a cohort of advanced cancer patients

Jacobsen, Juliet LU ; Vanderwerker, L ; Block, Susan ; Friedlander, Robert ; Maciejewski, Paul and Prigerson, Holly (2006) In Indian Journal of Palliative Care 12(1).
Abstract
The term demoralization has been used to describe existential distress and despair of patients with advanced disease. Aim: This study sought to determine whether a cluster of symptoms interpreted as demoralization could be identified and distinguished from a cluster of depressive symptoms. Materials and Methods: As part of the Coping with Cancer Study, a federally funded multi-site study of advanced cancer patients, 242 patients were interviewed on a broad range of mental health parameters related to depression, grief, quality of life, self-efficacy, coping and religiousness/spirituality. Results: A principal components analysis revealed separate depression and demoralization/despair factors. Seven symptoms constituted the... (More)
The term demoralization has been used to describe existential distress and despair of patients with advanced disease. Aim: This study sought to determine whether a cluster of symptoms interpreted as demoralization could be identified and distinguished from a cluster of depressive symptoms. Materials and Methods: As part of the Coping with Cancer Study, a federally funded multi-site study of advanced cancer patients, 242 patients were interviewed on a broad range of mental health parameters related to depression, grief, quality of life, self-efficacy, coping and religiousness/spirituality. Results: A principal components analysis revealed separate depression and demoralization/despair factors. Seven symptoms constituted the demoralization/despair factor: loss of control, loss of hope, anger/bitterness, sense of failure, feeling life was a burden, loss of meaning and a belief that life's meaning is dependent on health and were found to be internally consistent (Cronbach's a = 0.78). Only 14.8% of subjects with "syndromal demoralization" met DSM-IV criteria for Major Depression (MDD); 7.4% for Minor Depression. Of those with MDD only 28.6% had syndromal level demoralization. Prior history of MDD predicted current MDD, but not syndromal demoralization. Demoralization, not MDD, was significantly associated with the patient's reported level of inner peacefulness. When compared with MDD, syndromal demoralization was more strongly associated with wish to live and wish to die and equally predictive of mental health service use. Conclusion: The symptoms of demoralization are distinct from depressive symptoms and appear to be associated with the patient's degree of inner peacefulness (Less)
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author
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publishing date
type
Contribution to journal
publication status
published
in
Indian Journal of Palliative Care
volume
12
issue
1
publisher
Scientific Scholar LLC
external identifiers
  • scopus:33745743218
ISSN
0973-1075
language
English
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no
id
b97a8f05-17b2-4381-8ab6-43512ff530d6
alternative location
https://go.gale.com/ps/i.do?id=GALE%7CA147456718&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=09731075&p=HRCA&sw=w&userGroupName=anon%7Efc18b8e7&aty=open-web-entry
date added to LUP
2024-11-14 17:11:13
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2025-01-08 04:01:06
@article{b97a8f05-17b2-4381-8ab6-43512ff530d6,
  abstract     = {{The term demoralization has been used to describe existential distress and despair of patients with advanced disease. Aim: This study sought to determine whether a cluster of symptoms interpreted as demoralization could be identified and distinguished from a cluster of depressive symptoms. Materials and Methods: As part of the Coping with Cancer Study, a federally funded multi-site study of advanced cancer patients, 242 patients were interviewed on a broad range of mental health parameters related to depression, grief, quality of life, self-efficacy, coping and religiousness/spirituality. Results: A principal components analysis revealed separate depression and demoralization/despair factors. Seven symptoms constituted the demoralization/despair factor: loss of control, loss of hope, anger/bitterness, sense of failure, feeling life was a burden, loss of meaning and a belief that life's meaning is dependent on health and were found to be internally consistent (Cronbach's a = 0.78). Only 14.8% of subjects with "syndromal demoralization" met DSM-IV criteria for Major Depression (MDD); 7.4% for Minor Depression. Of those with MDD only 28.6% had syndromal level demoralization. Prior history of MDD predicted current MDD, but not syndromal demoralization. Demoralization, not MDD, was significantly associated with the patient's reported level of inner peacefulness. When compared with MDD, syndromal demoralization was more strongly associated with wish to live and wish to die and equally predictive of mental health service use. Conclusion: The symptoms of demoralization are distinct from depressive symptoms and appear to be associated with the patient's degree of inner peacefulness}},
  author       = {{Jacobsen, Juliet and Vanderwerker, L and Block, Susan and Friedlander, Robert and Maciejewski, Paul and Prigerson, Holly}},
  issn         = {{0973-1075}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Scientific Scholar LLC}},
  series       = {{Indian Journal of Palliative Care}},
  title        = {{Depression and demoralization as distinct syndromes: Preliminary data from a cohort of advanced cancer patients}},
  url          = {{https://go.gale.com/ps/i.do?id=GALE%7CA147456718&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=09731075&p=HRCA&sw=w&userGroupName=anon%7Efc18b8e7&aty=open-web-entry}},
  volume       = {{12}},
  year         = {{2006}},
}