| Generalized psychological distress, anxiety, and depression-like symptoms are common and understandable reactions to a cancer diagnosis. In the bone marrow transplant setting, the diagnosis and treatment of psychological distress is complicated by comorbid physical illness and treatment-related toxicities. A recently described five factor Demoralization Syndrome has been proposed as being related to, but distinct from, depression. Among demoralization researchers, anhedonia and self-perceived sense of failure are considered to be discriminating factors between depression and demoralization. This study examined the possibility of discriminating between depression and demoralization among 50 hospitalized adult bone marrow transplant patients. The findings confirm that depression and demoralization can be discriminated with two short scales. Individuals may experience depression, demoralization, or comorbid depression and demoralization. Anhedonia, but not self-perceived sense of failure, was found to be a discriminating factor, where anhedonia is associated with depression but not demoralization. These findings support the demoralization construct and represent a significant foundation for much needed research on the nature, diagnosis, and treatment of cancer related psychological distress. |
