Demoralization in acute coronary syndrome: Treatment and predictive factors associated with its persistence.

Background/objective: Although demoralization is associated with morbidity and mortality in cardiac settings, its treatment has been overlooked. The present randomized controlled trial aimed at 1) evaluating the effectiveness of sequential combination of Cognitive-Behavioral and Well-Being therapies (CBT/WBT), compared to Clinical Management (CM), on demoralization among Acute Coronary Syndromes (ACS) patients, at post-treatment and after 3 months; 2) examining ACS patients' characteristics predicting demoralization persistence at 3-month follow-up.

Method: 91 demoralized ACS patients were randomized to CBT/WBT ( = 47) or CM ( = 44).

Differential impact of resilience on demoralization and depression in Parkinson disease.

Objectives: The objective of this study was to study the interrelations of demoralization, depression, and resilience in patients with Parkinson disease, and, more specifically, to determine if higher resilience in patients with Parkinson disease is associated with lower demoralization, lower depression, or both.

Methods: Outpatients with Parkinson disease ( = 95) were assessed for demoralization, depression, and resilience, as well as sociodemographic, clinical, and treatment-related variables. Bivariable associations, standard regressions, linear regression with copula correction, and correspondence analysis were used to analyze the data.

From Perceived Stress to Demoralization in Parkinson Disease: A Path Analysis.

Objectives: The objective of this study was to determine whether depression and anxiety are mediators between perceived stress and demoralization via a loss of the cognitive map to get out of the predicament manifesting as subjective incompetence.

Methods: Ninety-five consecutive outpatients with Parkinson's disease were evaluated for perceived stress, depression, anxiety, subjective incompetence, and demoralization using reliable and valid scales. Inclusion criteria were ages 40-90, intact cognition, and no current history of substance use.

Negative health outcomes in depressed cardiac patients are associated with both low and high psychological well-being dimensions.

Literature supports the positive effects of psychological well-being (P.W.B.

Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity.

Objective: Essential tremor (ET) is associated with psychological difficulties, including anxiety and depression. Demoralization (feelings of helplessness, hopelessness, inability to cope), another manifestation of psychological distress, has yet to be investigated in ET. Our objectives are to (1) estimate the prevalence of demoralization in ET, (2) assess its clinical correlates, and (3) determine whether demoralization correlates with tremor severity.

Demoralization in Parkinson disease.

Objective: To determine the prevalence and associated features of demoralization in Parkinson disease (PD).

Methods: Participants with PD and controls were prospectively recruited from outpatient movement disorder clinics and the community. Demoralization was defined as scoring positively on the Diagnostic Criteria for Psychosomatic Research, Demoralization questionnaire or Kissane Demoralization Scale score ≥24.

Culture and demoralization in psychotherapy.

In most societies, members of a culture have attempted to help each other in times of trouble with various types of healing methods. Demoralization - an individual experience related to a group phenomenon - responds to certain elements shared by all psychotherapies. This article has three objectives: (1) to review the theoretical background leading to our current views on culture and demoralization in psychotherapy, (2) to discuss the methodological challenges faced in the cross-cultural study of demoralization and psychotherapy, and (3) to describe the clinical applications and research prospects of this area of inquiry.

Explaining the 'immigration advantage' and the 'biculturalism paradox': an application of the theory of demoralization.

Background: Recent immigrants have better mental health than the natives ('immigration advantage'). Biculturals have better mental health than the monoculturals ('biculturalism paradox').

Material: Mexican immigrants have lower rates of psychopathology than the U.

Prevention of demoralization in prolonged bicultural conflict and interaction: the role of cultural receptors II - genesis of hybridization.

Background: The objective of this article is to show that bicultural hybridization for the prevention of demoralization is anchored on the discovery of certain thematic areas (cultural receptors) in which social roles or cultural mandates are missing, unclear, ambiguous or congruent.

Material: The specific setting is the history of Goa, a former Portuguese territory on the western coast of India. Both published and unpublished sources of information were studied.

Prevention of demoralization in prolonged bicultural conflict and interaction: the role of cultural receptors I - description of a natural experiment.

Background: This article examines how symbols and sentiments are exchanged to produce a synthesis of two cultures in the context of prolonged bicultural conflict and interaction, thereby minimizing or preventing sociocultural disintegration and the resulting demoralization. This process will be shown to be anchored on the discovery of certain thematic areas (cultural receptors) in which social roles or cultural mandates are missing, unclear, ambiguous or congruent.

Material: The setting of this research is the history of Goa, a former Portuguese state on the western coast of India, where the exchange between the Portuguese and Indian cultures lasted longer than four centuries (1510-1961).

The making of a multicultural psychiatrist.

The author grew up in Goa, a unique bicultural setting on the western coast of India. Goa came under Portuguese rule in 1510 AD and remained under the Portuguese until 1961 when it became part of India. The Indian and Portuguese cultures interacted in Goa and led the Goans to create an interesting blend in which elements of both cultures were made to reconcile.

Diagnosis and measurement of subjective incompetence: the clinical hallmark of demoralization.

Background: This article presents the development and application of a method to diagnose and measure subjective incompetence, the clinical hallmark of demoralization.

Methods: The subjects (n = 112) were patients with cancer at a consultation clinic of a cancer center. They completed a questionnaire on general background information, the Brief Cope Scale, and a newly developed scale to measure subjective incompetence.

Recent treatment history vs clinical characteristics in the prediction of use of outpatient psychiatric services.

Background: The use of outpatient psychiatric services has been shown to be a complex function of sociodemographic, clinical, and pathway variables. The relative contribution of each variable or groups of variables in explaining the variability in the use of outpatient psychiatric services, however, remains poorly documented.

Methods: The subjects (N=382) were all patients admitted to an outpatient psychiatric clinic serving mostly a minority and low-income population.

Pathways of low-income minority patients to outpatient psychiatric treatment.

Objective: Low-income outpatients with scheduled appointments ("scheduled patients") were compared with those who sought treatment without appointments ("walk-ins").

Method: The charts of scheduled patients and walk-ins at an outpatient mental health clinic serving a low-income group were reviewed to determine sociodemographic and clinical characteristics and patients' pathways to treatment.

Results: Walk-ins (N=241) outnumbered scheduled patients (N=141).

Methodological aspects of comparative research in the epidemiology of Alzheimer disease.

In recent years, major advances have been made in the investigation of the incidence and prevalence of Alzheimer disease in diverse social and cultural settings. Examples of issues being addressed are the methods used to estimate incidence and prevalence, the procedures for data collection and its harmonization, the definitions of numerator (cases) and denominator (population at risk), and the modeling of cognitive decline. This type of research will eventually lead to a better understanding of how protective and modifiable risk factors interact with the genotype to produce this disease.