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Diagnosis and Treatment of Demoralization 

Diagnosis and Treatment of Demoralization
Chapter:
Diagnosis and Treatment of Demoralization
Author(s):

David W. Kissane

DOI:
10.1093/med/9780190491857.003.0003
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date: 23 October 2019

Low morale can develop from a sense of poor coping with a predicament that cannot be changed, often encountered with progressive diseases like advanced cancer. The prevalence of clinically significant demoralization in patients with cancer is 15%. Demoralization can be diagnosed when a poor sense of coping is associated with low morale, reduced hope, and a sense of feeling stuck, with related symptoms of feeling helpless, pointless or purposeless, and with doubts about the value of continued life. Meaning-based coping may need to be evoked to reduce the accompanying distress and social and functional impairment that can develop. Diagnoses like demoralization syndrome, adjustment disorder with demoralization, and major depression with demoralization help to guide the optimal choice of treatment. Cognitively informed and existentially oriented therapies can help to restore morale and sustain engagement with the living.

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