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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 M (SD) ¼ 30.8 (17.7) 0.90 Mangelli et al. (2005)26; Rafanelli et al. (2013)15; Sirri et al. (2012)16 Italy Rates of demoralization and depression?”
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“This definition is vague in the oncology setting; thus alternative diagnoses (eg, demoralization syndrome) are currently being evaluated.(17,18) However, it is useful to think of an adjustment disorder as symptoms of situational anxiety or depression that are distressing enough to warrant treatment but that are not so…”
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“…(see the above paragraph) that can be of impact in medically ill patients (Fava et al., 2012; Grassi, Mangelli, et al., 2007; Guidi et al., 2011; Mangelli et al., 2005, 2006; Porcelli et al., 2012, 2013), influencing illness representation and beliefs about medicines (Grassi, Meggiolaro, et…”
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“…coincide with diagnoses of MDD in an extensive medical patient sample with varying diagnoses (Guidi et al. 2011), in medical outpatients (Mangelli et al. 2005), in inpatients (Galeazzi et al. 2004), in the context of primary care (Ferrari et al. 2008), cardiac transplantation (Grandi et…”
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Metadata
- 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
- Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
- Health Sciences › Medicine › Pharmacology (medical) › 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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