Citation

Kissane DW, Clarke DM, Street AF. J. Palliat. Care 2001; 17(1): 12-21.

Copyright

(Copyright © 2001, Clinical Research Institute of Montreal, Center for Bioethics)

DOI

unavailable

PMID

11324179

Abstract

Hopelessness, loss of meaning, and existential distress are proposed as the core features of the diagnostic category of demoralization syndrome. This syndrome can be differentiated from depression and is recognizable in palliative care settings. It is associated with chronic medical illness, disability, bodily disfigurement, fear of loss of dignity, social isolation, and--where there is a subjective sense of incompetence--feelings of greater dependency on others or the perception of being a burden. Because of the sense of impotence or helplessness, those with the syndrome predictably progress to a desire to die or to commit suicide. A treatment approach is described which has the potential to alleviate the distress caused by this syndrome. Overall, demoralization syndrome has satisfactory face, descriptive, predictive, construct, and divergent validity, suggesting its utility as a diagnostic category in palliative care.

Language: en

Keywords

Body Image; Depressive Disorder; Diagnosis, Differential; Fear; Helplessness, Learned; Humans; Internal-External Control; Morale; Predictive Value of Tests; Social Isolation; Stress, Psychological; Suicide; Syndrome; Terminal Care