Some evidence from American studies buttresses that from Italian research
that demoralization is common among persons who have heart disease, cancer, or
other kinds of medical conditions (see story above).
The American evidence comes from James Griffith, M.D., and Lynne Gaby,
M.D., of the consultation-liaison psychiatry faculty at George Washington
University Medical Center in Washington, D.C.
Griffith told Psychiatric News that several years ago he and Gaby
reviewed 100 psychiatric consultations that had been conducted either by
themselves or by psychiatry residents they supervised. All of the
consultations had been undertaken in response to medical and surgical
colleagues' request to "evaluate and treat a patient's
depression," which is the most common reason why medical colleagues ask
them to consult on their cases.
Griffth and Gaby found that in 52 of the 100 consultations, patients had
been given "a depressive disorder" as the primary psychiatric
diagnosis (the average Hamilton Depression Rating Scale score was 20), whereas
in the remaining 48 consultations, patients had been given"
demoralization" as the primary psychiatric descriptor (the
average Hamilton score was 11, which is just higher than the normal
Thus, demoralization rather than a mood disorder was the major problem for
many of these patients, Griffith said.
Moreover, Griffith continued, "We have learned that these patients
respond quickly and robustly to two kinds of interventions.... [The
interventions are] taking immediate steps at the bedside to relieve either
physical or emotional suffering and helping patients regain a sense of hope or
dignity or purpose in living that they lost."
For example, Griffith explained, a psychiatrist can do the following:
Griffith and Gaby offered other suggestions on how to help demoralized
patients, as well as vignettes illustrating those suggestions, in the April
The article "Brief Psychotherapy at the Bedside: Countering
Demoralization From Medical Illness" is posted online at<http://psy.psychiatryonline.org/cgi/content/full/46/2/109>.▪