Assessing demoralization and depression in the setting of medical disease.
OBJECTIVE
The aim of this study was to assess the presence of demoralization and major depression in the setting of medical disease.


METHODS
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 major depression.


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.
Mangelli
Lara
L
Department of Psychology, University of Bologna, 40127 Bologna, Italy.
Fava
Giovanni A
GA
Grandi
Silvana
S
Grassi
Luigi
L
Ottolini
Fedra
F
Porcelli
Piero
P
Rafanelli
Chiara
C
Rigatelli
Marco
M
Sonino
Nicoletta
N
D000275:Adjustment Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D001294:Attitude to Health; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology