Prevalence, Associated Factors and Adverse Outcomes of Demoralization in Cancer Patients: A Decade of Systematic Review

Abstract

Demoralization has been extensively studied in oncology and palliative care settings, and is characterized by a loss of meaning and purpose in life, a sense of powerlessness over life events, and a sense of helplessness. The objective of this systematic review is to synthesize the prevalence, associated factors, and adverse outcomes of demoralization in cancer patients by reviewing the literature of the last decade. Seven databases (PubMed, PsycINFO, Embase, Web of Science, Medline, CINAHL and Cochrane Library databases) were systematically searched from January 2012 to June 2022. Roughly speaking, the prevalence of demoralization in cancer patients ranges from 13.50% to 49.4%. A total of 45 factors are associated with demoralization, of which psychological factors have been studied more frequently in the last decade. There are nine outcomes related to demoralization, with the strongest evidence for the correlation between demoralization and suicidal ideation. The study emphasizes the complexity of factors associated with demoralization in cancer patients. There appears to be a intersection between the constructs of demoralization and depression, anxiety, and suicidal ideation, which may explain the correlation between them.

Review of Psilocybin Use for Depression among Cancer Patients after Approval in Oregon

“…Recognizing demoralization as a separate entity from depression and identifying its unique impact on patients' well-being can lead to more targeted interventions and improved outcomes. Studies have shown that demoralization is prevalent in this population, with rates ranging from 13% to 50% [12]. Demoralization often coexists with depression, anxiety, adjustment disorders, and suicidal ideation in cancer patients [12][13][14].…”

“…Studies have shown that demoralization is prevalent in this population, with rates ranging from 13% to 50% [12]. Demoralization often coexists with depression, anxiety, adjustment disorders, and suicidal ideation in cancer patients [12][13][14]. While demoralization and depression share similarities, they are distinct conditions, with demoralization characterized by feelings of subjective incompetence and a lack of hope [15,16].…”

Demoralization in cancer survivors: an updated systematic review and meta‐analysis for quantitative studies

“…9 Additionally, the prevalence of demoralization in cancer patients is high, ranging from 13.5% to 49.4%. 10 Studies in recent years have indicated that demoralization syndrome alone, without comorbid depression, can serve as an independent risk factor for subsequent suicide risk among cancer patients. 11 The concept of demoralization originally arose from those who were suffering and their meaning-seeking as a coping strategy, as depicted by a psychiatrist.…”

“…Additionally, the prevalence of demoralization in cancer patients is high, ranging from 13.5% to 49.4% 10 . Studies in recent years have indicated that demoralization syndrome alone, without comorbid depression, can serve as an independent risk factor for subsequent suicide risk among cancer patients 11 .…”

Collective Impacts of Demographic and Clinical Factors on Psycho-emotional States of Patients with Hepatocellular Carcinoma: A Cross-Sectional Study

“…Patients with good family support and high degree of education are less likely to experience demoralization. Regardless of the type of malignancy or geographic location, the rate of demoralization among patients with cancer ranges from 13% to 49% (Ko et al, 2018; Tang et al, 2020, Wang et al, 2023).…”