Demoralization syndrome as an alternative diagnostic to depressed mood in palliative patients

Abstract

The emotional state of palliative patients is one of the main aims in their professional attention. Several authors have approach this matter using depression definitions as defined for the general population. There are also many expert professional opinions and research data pointing to the need for adequate research at the patient’s end of life situation. Perhaps one of the most interesting ideas is that one initia­lly expressed by Frank and developed by Kis­sanne et al., suggesting differentiation between depression and demoralization. Following this line of thought, demoralization would more accurately reflect the situation observed in these patients, allows a better differential diagnosis and promotes more tailored inter­ventions. Demoralization syndrome would be defined as the presence of discouragement, despair, helplessness, loss of meaning in life and feelings of failure. That approach leaves aside somatic symptoms of depression scores. This work exposes a critical view and being thought-provoking about current interventions in palliative care. a definición, las intervenciones psicológicas tendrían unos objetivos operativos distintos al tratamiento de depresión, obteniéndose resul­tados en el bienestar del paciente paliativo. En este trabajo se realiza un planteamiento crítico y se invita a reflexionar sobre las intervencio­nes psicológicas que actualmente se llevan a cabo en pacientes paliativos.