Differentiating Depression From Demoralization in Organ Transplantation Recipients

Prog Transplant. 2021 Mar;31(1):88-90. doi: 10.1177/1526924820978602. Epub 2020 Dec 21.

Abstract

Living with end stage organ failure and transplantation has implications for physiological, psychological, and social well-being. The development of anxiety or depressive disorders are common with demoralization, another psychological syndrome, a topic of interest in psychiatry. To feel demoralized is to lose hope, courage, or confidence, which upsets normal functioning. While depression may co-exist with demoralization, they are 2 distinct entities, with the former characterized by an inability to experience pleasure and the latter characterized by helplessness and avoidance coping. In an effort to more adequately address the psychological stress in organ transplant patients, it is important to distinguish between demoralization and depression. Demoralization has prognostic implications such as negative disease outcomes such as treatment nonadherence and an increase risk of suicide. Medication for depression is not effective for demoralization syndrome. Therapeutic interventions include cognitive behavioral techniques that focus on exploration of attitudes toward hope and meaning in life.

Keywords: behavior and behavior mechanisms; demoralization in organ transplant; depression in organ transplant; heart transplant recipient < body regions; kidney transplant recipient < body regions; liver transplant recipient < body regions; mental health in organ transplant.

MeSH terms

  • Anxiety
  • Demoralization*
  • Depression / diagnosis
  • Humans
  • Organ Transplantation*
  • Stress, Psychological