Demoralization: a systematic review on its clinical characterization

Tecuta, Lucia; Tomba, Elena; Grandi, Silvana; Fava, Giovanni A.

doi:10.1017/s0033291714001597

Cited by 141 publications

(135 citation statements)

References 132 publications

(381 reference statements)

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“…Demoralization is defined as a psychological state characterized by both hopelessness and helplessness, and the inability to cope with stress that is expected to be handled by every individual [26, 27]. It is therefore possible that the symptoms experienced by the patient and assessed with the DASS-21 at admission are more likely to reflect a temporary negative emotional state due to the factors mentioned before, rather than a depressive disorder.…”

Section: Discussionmentioning

confidence: 99%

The Depression, Anxiety and Stress Scale (DASS-21) as a Screener for Depression in Substance Use Disorder Inpatients: A Pilot Study

Beaufort¹,

Oene²,

Buwalda³

et al. 2017

Eur Addict Res

152

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Depression is a common co-morbid disorder in substance use disorder (SUD) patients. Hence, valid instruments are needed to screen for depression in this subpopulation. In this study, the predictive validity of the Depression, Anxiety and Stress Scale (DASS-21) for the presence of a depressive disorder was investigated in SUD inpatients. Furthermore, differences between DASS-21 scores at intake and those recorded one week after inpatient detoxification were assessed in order to determine the measurement point of the assessment of the DASS-21 leading to the best predictive validity. The DASS-21 was administered to 47 patients at intake and shortly after inpatient detoxification. The results of the DASS-21 were compared to the Mini International Neuropsychiatric Interview (MINI), which served as the gold standard. Levels of sensitivity and specificity of 78–89% and 71–76% were found for the DASS-21 assessed after detoxification, satisfactorily predicting depression as diagnosed with the MINI. Total DASS-21 scores as well as the DASS subscale for depression were significantly reduced at the second measurement, compared to the DASS at intake. We conclude that the DASS-21 may be a suitable instrument to screen for depressive disorders in SUD patients when administered (shortly) after detoxification. Future research is needed to support this conclusion.

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Section: Discussionmentioning

confidence: 99%

The Depression, Anxiety and Stress Scale (DASS-21) as a Screener for Depression in Substance Use Disorder Inpatients: A Pilot Study

Beaufort¹,

Oene²,

Buwalda³

et al. 2017

Eur Addict Res

152

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Section: Psychosomatic Assessment and Individualized Carementioning

confidence: 99%

“…Demoralization and major depression can be differentiated on clinical grounds; they may occur together or independently, and major depression does not necessarily involve demoralization [106]. DCPR studies on demoralization reported very low prevalence in healthy participants (not higher than 2-5%) and a high prevalence in the medically ill (about 30%) [106]. Table 12 shows the revised DCPR criteria for demoralization and its two different expressions: helplessness (the individual maintains the capacity to react but lacks adequate support) and hopelessness (when the individual feels he/she alone is responsible for the situation and there is nothing he/she or anyone else can do to overcome the problem) [107].…”

Section: Psychosomatic Assessment and Individualized Carementioning

confidence: 99%

Current Psychosomatic Practice

Fava

Cosci²,

Sonino³

2016

Psychother Psychosom

252

317

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Psychosomatic research has advanced over the past decades in dealing with complex biopsychosocial phenomena and may provide new effective modalities of patient care. Among psychosocial variables affecting individual vulnerability, course, and outcome of any medical disease, the role of chronic stress (allostatic load/overload) has emerged as a crucial factor. Assessment strategies include the Diagnostic Criteria for Psychosomatic Research. They are presented here in an updated version based on insights derived from studies carried out so far and encompass allostatic overload, type A behavior, alexithymia, the spectrum of maladaptive illness behavior, demoralization, irritable mood, and somatic symptoms secondary to a psychiatric disorder. Macroanalysis is a helpful tool for identifying the relationships between biological and psychosocial variables and the individual targets for medical intervention. The personalized and holistic approach to the patient includes integration of medical and psychological therapies in all phases of illness. In this respect, the development of a new psychotherapeutic modality, Well-Being Therapy, seems to be promising. The growth of subspecialties, such as psychooncology and psychodermatology, drives towards the multidisciplinary organization of health care to overcome artificial boundaries. There have been major transformations in health care needs in the past decades. From psychosomatic medicine, a land of innovative hypotheses and trends, many indications for changes in the current practice of medicine are now at hand. The aim of this critical review is to outline current and potential clinical applications of psychosomatic methods.

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“…Demoralization is a psychological state characterized by helplessness, hopelessness, sense of failure and a feeling of inability to cope [4,5]. Frank's [4] original clinical hypothesis argues that demoralized patients more frequently and actively seek psychotherapy and respond readily to help and encouragement, that is to nonspecific psychotherapeutic factors.…”

Section: Figmentioning

confidence: 99%

Demoralization and Response to Psychotherapy: A Pilot Study Comparing the Sequential Combination of Cognitive-Behavioral Therapy and Well-Being Therapy with Clinical Management in Cyclothymic Disorder

Tomba

Tecuta²,

Guidi³

et al. 2015

Psychother Psychosom

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Demoralization: a systematic review on its clinical characterization

Abstract: Studies addressing the incremental value of demoralization in psychiatry and psychology are needed. However, demoralization appears to entail specific clinical features and may be a distinct condition from major depression.

Cited by 141 publications

References 132 publications

The Depression, Anxiety and Stress Scale (DASS-21) as a Screener for Depression in Substance Use Disorder Inpatients: A Pilot Study

The Depression, Anxiety and Stress Scale (DASS-21) as a Screener for Depression in Substance Use Disorder Inpatients: A Pilot Study

Current Psychosomatic Practice

Demoralization and Response to Psychotherapy: A Pilot Study Comparing the Sequential Combination of Cognitive-Behavioral Therapy and Well-Being Therapy with Clinical Management in Cyclothymic Disorder

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