Demoralization in Opioid Dependent Patients: A Comparative Study with Cancer Patients and Community Subjects

Contains fulltext : 73016.pdf (publisher's version ) (Open Access)Aim: To study existential distress or demoralization expressed as meaninglessness and helplessness in opioid dependent patients. xxx Method: Comparison of existential distress between opioid dependent patients (n=131), patients with advanced cancer (n=100) and a community based sample without severe psychiatric or somatic disorders (n=190) as measured with the Demoralization Scale. xxx Results: Community controls without somatic or psychiatric disorders have significantly lower scores on all Demoralization Subscales. Opioid dependent patients are strikingly more demoralized than patients with cancer. xxx Conclusion: Opioid dependent patients suffer from severe existential distress (meaninglessness, helplessness) which can explain the high prevalence of suicide in this group

End games: Euthanasia under interminable scrutiny

It is increasingly asserted that the disagreements of abstract principle between adversaries in the euthanasia debate fail to account for the complex, particular and ambiguous experiences of people at the end of their lives. A greater research effort into experiences, meaning, connection, vulnerability and motivation is advocated, during which the euthanasia 'question' should remain open. I argue that this is a normative strategy, which is felicitous to the status quo and further medicalises the end of life, but which masquerades as a value-neutral assertion about needing more knowledge

High demoralization in a minority of oophorectomized BRCA1/2 mutation carriers influences quality of life

Contains fulltext : 190195.pdf (publisher's version ) (Open Access)Introduction: Demoralization is a relatively neglected issue in which low morale and poor coping result from a stressor such as familial cancer risk. Female BRCA1/2 mutation carriers are highly susceptible for developing breast and ovarian cancer. The aim of this study was to evaluate demoralization in oophorectomized BRCA1/2 mutation carriers and its relation to quality of life. Methods: This cross-sectional study examined 288 oophorectomized BRCA1/2 mutation carriers using the following standardized self-report measures: Demoralization Scale, EORTC Quality of Life Questionnaire-C30, State-Trait Anxiety Inventory and the Cancer Worry Scale. Results: The mean score on the Demoralization Scale was 17.8 (SD 14.0). A clinically significant level of demoralization, defined as a score >=30, was found in 45 BRCA1/2 mutation carriers (16%). Being highly demoralized was associated with a significantly lower quality of life, and higher levels of physical problems, anxiety and cancer worries. No demographic or clinical factors could predict higher levels of demoralization. Conclusions: Our findings established that a clear proportion of oophorectomized BRCA1/2 mutation carriers experience demoralization impacting on their well-being. Further research is needed to explore the natural trajectory of demoralization and the resultant need for support in these women.9 p