Affective disorders at the end of life: demoralization or depression?

Abstract

This paper analyzes problems that result in an alteration of mood, particularly in the sadness found in people with a serious physical illness at the end of life. The problems and implications of an faulty diagnosis, the confusions associated with a diagnosis of depression, and the importance of differen-tiation between “normal” mood reactions to illness, and pathological reactions, are analyzed. Several studies are reviewed and analyzed that propose the incorporation of a new syndrome to the traditional psychiatric classifications: demoralization. Finally the implications, advantages, and inconveniences of including a demoralization syndrome are discussed.