Assessing demoralization and depression in the setting of medical disease
Open accessAbstract
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 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.
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“Demoralization has been found to have an adverse impact on a broad range of medical conditions, including cardiology, bariatric surgery, and oncology among others (Mangelli et al., 2005; Marek, Ben-Porath, Merrell, Ashton, & Heinberg, 2014).”
BackgroundThe Experience of Emotional Distress Among Women With Scleroderma
Newton, E. G., Thombs, B. D., & Groleau, D. (2012) · Qualitative Health Research · doi:10.1177/1049732312449207 · Cited by 21 · see citing works
“…of patients with a variety of medical conditions who underwent a semistructured interview for both depression and demoralization, many were diagnosed with both, but enough patients received a diagnosis of either one or the other to suggest that they are distinct syndromes (Mangelli et al., 2005).”
BackgroundPsychological Factors Affecting Functional Gastrointestinal Disorders
Porcelli, P., & Todarello, O. (2007) · KARGER eBooks · doi:10.1159/000106796 · Cited by 21 · see citing works
Self-citationBobevski, I., Rowe, H. J., Clarke, D. M., McKenzie, D. P., & Fisher, J. (2014) · Archives of Women s Mental Health · doi:10.1007/s00737-014-0486-8 · Cited by 18 · see citing works
Cersonsky, T. E. K., Kellner, S., Morgan, S., Cosentino, S., Koo, B. B., de Figueiredo, J. M., & Louis, E. D. (2019) · CNS Spectrums · doi:10.1017/s1092852918001633 · Cited by 20 · see citing works
The Use of Demoralization Scale in Italian Kidney Transplant Recipients
Battaglia, Y., Zerbinati, L., Piazza, G. G., Martino, E., Massarenti, S., Provenzano, M., Esposito, P. B., Andreucci, M., Storari, A., & Grassi, L. G. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9072119 · Cited by 20 · see citing works
Self-citationDevelopment of the Remoralization Scale
Vissers, W., Keijsers, G. P. J., van der Veld, W. M., de Jong, C. A. J., & Hutschemaekers, G. J. M. (2010) · European Journal of Psychological Assessment · doi:10.1027/1015-5759/a000039 · Cited by 19 · see citing works
“In this light, several scholars have questioned whether depression and demoralization can be treated as distinct concepts because they both accompany symptoms of distress, despair, impotence, hopelessness, and loss of meaning (Mangelli et al., 2005).”
BackgroundThe Prevalence of Depression in People with Cancer
Massie, M. J., Lloyd‐Williams, M., Irving, G. J., & Miller, K. (2010) · doi:10.1002/9780470972533.ch1 · Cited by 17 · see citing works
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“Adjustment Disorders are emotional/behavioral symptoms in excess of what would be normal response to a given stressor in excess of a mere diagnosis of depression” ([176], also see [4]).”
BackgroundPATTERNS OF SYMPTOM ONSET AND REMISSION IN EPISODES OF HOPELESSNESS DEPRESSION
Iacoviello, B. M., Alloy, L. B., Abramson, L. Y., Choi, J. Y., & Morgan, J. E. (2013) · Depression and Anxiety · doi:10.1002/da.22085 · Cited by 17 · see citing works
“[20] However, research has demonstrated that depression and demoralization are distinct clinical phenomena,[21] and the HD subtype extends beyond just the symptom of hopelessness.”
BackgroundSubtyping demoralization in the medically ill by cluster analysis
Rafanelli, C., Guidi, J., Gostoli, S., Tomba, E., Porcelli, P., & Grandi, S. (2013) · The European Journal of Psychiatry · doi:10.4321/s0213-61632013000100002 · Cited by 16 · see citing works
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Self-citationPsychological aspects of endocrine disease
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Porcelli, P., & Todarello, O. (2011) · Advances in psychosomatic medicine · doi:10.1159/000330009 · Cited by 14 · see citing works
Self-citationDemoralization in Patients With Substance Use and Co-Occurring Psychiatric Disorders
Oene, G. H. D. W.-V., Markus, W., Kissane, D. W., & de Jong, C. A. J. (2017) · Journal of Dual Diagnosis · doi:10.1080/15504263.2017.1287457 · Cited by 14 · see citing works
“Previous studies (De Figueiredo, 1983; Mangelli et al., 2005) have shown an overlap between demoralization and states of distress, which have been experienced more frequently in mood and anxiety disorders.”
BackgroundBlock, A. R., Marek, R. J., Ben‐Porath, Y. S., & Ohnmeiss, D. D. (2014) · Journal of Applied Biobehavioral Research · doi:10.1111/jabr.12028 · Cited by 14 · see citing works
Lu, M., Yang, Y., Wang, G., Wang, H., & Feng, D. (2022) · Mindfulness · doi:10.1007/s12671-022-02011-5 · Cited by 13 · see citing works
Psychological correlates of vasovagal versus medically unexplained syncope
Rafanelli, C., Gostoli, S., Roncuzzi, R., & Sassone, B. (2013) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2013.01.008 · Cited by 13 · see citing works
“The clinical relevance of demoralization in medical diseases is highlighted by its high prevalence in all medical settings and its low frequency among healthy people [27,66].”
BackgroundSelf-citation
- Authors
- Mangelli, L., Fava, G. A., Grandi, S., Grassi, L., Ottolini, F., Porcelli, P., Rafanelli, C., Rigatelli, M., & Sonino, N.
- Affiliations
- University of Bologna (IT)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2005-03-15
- Volume
- 66
- Issue
- 03
- Pages
- 391-394
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2170980087
- Cited by
- 158
- References
- 0
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 3 · 2020: 9 · 2019: 5 · 2018: 10 · 2017: 10 · 2016: 7 · 2015: 6 · 2014: 8 · 2013: 10 · 2012: 6
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- cc-by
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- demoralization, major depressive disorder, disease, psychiatric comorbidity, prevalence, psychosomatic medicine, diagnostic overlap
- MeSH terms
- Adjustment Disorders, Attitude to Health, Depressive Disorder, Female, Health Status, Humans, Italy, Male, Middle Aged, Outpatients, Psychiatric Status Rating Scales, Stress, Psychological, Prevalence
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