title: Demoralisation--a useful conceptualisation of non-specific psychological distress among refugees attending mental health services.
abstract: BACKGROUND
  While it is recognised that many refugee and migrant clients present at mental health services with non-specific psychological distress little is known about successful intervention strategies.
  
  
  OBJECTIVE
  The aim of this study was to systematically review clinical files to determine the degree of 'demoralisation' symptoms among a sample of refugee and migrant clients attending a community-based mental health service.
  
  
  METHODS
  Sixty-four closed cases were reviewed using a specifically designed case review sheet as a checklist which included diagnostic criteria for a Demoralisation Syndrome.
  
  
  RESULTS
  The findings indicated that while many of the refugee and migrant clients had attracted a diagnosis of major depressive disorder, in the main they did not benefit from a normal course of treatment. Further analysis suggested that demoralisation may be a preferable concept for many of these clients rather than affective disorder. This finding suggests that demoralisation may be a different construct than low mood or depression.
  
  
  CONCLUSIONS
  The findings add support to the concept that demoralisation could be a distinct diagnostic entity in its own right that may be useful to clinicians attending refugee and migrant clients.
authors.affiliation: Community and Family Studies Department, University of Otago, Dunedin, New Zealand. Lynne.Briggs@cdhb.govt.nz
authors.forename: Lynne
authors.initials: L
authors.lastname: Briggs
authors.forename: A D Sandy
authors.initials: AD
authors.lastname: Macleod
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012036:Refugees / Q000523:psychology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*