ArticleCancer medicine2022
Demoralisation and its link with depression, psychological adjustment and suicidality among cancer patients: A network psychometrics approach.
Article in Cancer medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Factors correlated with demoralization among cancer patients: A systematic review and meta-analysis.Palliative & supportive care · 2025Pooled it
- Psychological and spiritual interventions to enhance meaning in adults diagnosed with cancer: a systematic review with meta-analysis and meta-regression.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- Characteristics and influencing factors of demoralization in ovarian cancer: a latent profile analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Observational
- Hope and despair in cancer and other illnesses: a clinical framework for adaptive hope across the illness trajectory.ESMO open · 2026Review
- Young Women With Pancreatic Cancer: A High-Risk Group for Demoralization.Psycho-oncology · 2026Article
- Addressing Existential Distress Through Compassion: Feasibility and Preliminary Effects of Compassion With You (COMwithU), a Compassion-Based Intervention for Patients With Cancer.Psycho-oncology · 2026Article
- Demoralization and Associated Factors in Palliative Oncology Outpatients: A Cross-Sectional Study.Psycho-oncology · 2026Article
- It's all about the relationship: The caregiver experience of supporting a person with advanced cancer going through an LSD microdosing trial.Palliative & supportive care · 2026Article
- Development and validation of a risk prediction model for demoralization syndrome in patients with type 2 diabetes.Frontiers in public health · 2026Observational
- How demoralization is related to trait resilience factors: a network analysis in a representative sample of the general population.BMC psychiatry · 2025Article
- Social emotional distress, psychological adjustment, life satisfaction, and resilience: validation of the Turkish version of the social emotional distress survey-secondary-brief.BMC psychology · 2025Article
- Network analysis used to investigate the interplay among somatic and psychological symptoms in patients with cancer and cancer survivors: a scoping review.Journal of cancer survivorship : research and practice · 2025Article
- A longitudinal observational study of demoralization within 6 months following cancer diagnosis: a cross-lagged panel network analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Demoralization: A concept analysis through a scoping review methodology.International journal of nursing studies advances · 2025Article
- The status and determinants of demoralization in patients with colorectal cancer: a cross-sectional study in China.Journal of cancer research and clinical oncology · 2025Article
- Symptom Network Analysis in Patients Undergoing Chemotherapy for Colorectal Cancer: A Cross-Sectional Study.Cancer management and research · 2025Article
- Demoralization in breast cancer survivors.Frontiers in psychology · 2025Article
- Core and bridge symptoms of demoralization in Chinese female cancer patients: a network analysis.Frontiers in psychiatry · 2024Article
- Older adults coping with critical life events - results of the revised demoralization scale in a representative sample of older adulthood.Frontiers in psychiatry · 2024Article
- Demoralization and well-being among self-employed individuals with cardiac disease: the role of intolerance of uncertainty.Frontiers in psychology · 2024Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDemoralisation is a clinically significant problem among cancer patients with a prevalence of 13%-18%. It is defined by difficulty in adjusting to a stressor, wherein the person feels trapped in their predicament and experiences helplessness, hopelessness, loss of confidence and loss of meaning in life. Demoralisation has a strong link with the desire for hastened death and suicidal ideation among the medically ill. This study explored whether a group of symptoms could be identified, distinct from depression, but consistent with adjustment difficulties with demoralisation and linked to ideation of death and suicide.
methodsExploratory Graph Analysis, a network psychometrics technique, was conducted on a large German study of 1529 cancer patients. Demoralisation was measured with the Demoralisation Scale II and depressive symptoms with the PHQ-9.
resultsA network of symptoms, with four stable communities, was identified: 1. Loss of hope and meaning; 2. Non-specific emotionality; 3. Entrapment; 4. Depressive symptoms. The first three communities were clearly distinct from the PHQ-9 depressive symptoms, except for suicidality and fear of failure. Community 1, Loss of hope and meaning, had the strongest association with thoughts of death and suicide. Hopelessness, loss of role in life, tiredness, pointlessness and feeling trapped were the most central symptoms in the network.
conclusionsCommunities 1 to 3 are consistent with poor coping without anhedonia and other classic depression symptoms, but linked to suicidal ideation. For people facing the existential threat of cancer, this may indicate poor psychological adjustment to the stressors of their illness.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.