Demoralization syndrome - a relevant psychiatric diagnosis for palliative care

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 palli ative care settings. it is associated with chronic medical illness, disabil ity, bodily disfigurement, fear of loss of dignity, social isolation, and - where there is a subjective sense of incompetence - feelings of greater de pendency on others or the perception of being a burden. Because of the sens e of impotence or helplessness, those with the syndrome predictably progres s to a desire to die or to commit suicide. A treatment approach is describe d which has the potential to alleviate the distress caused by this syndrome . Overall, demoralization syndrome has satisfactory face, descriptive, pred ictive, construct, and divergent validity, suggesting its utility as a diag nostic category in palliative care.