Journal Article Annotations
2022, 2nd Quarter
Annotations by Liliya Gershengoren MD
Based on a systematic review including 18 clinical studies, demoralization is a relevant risk factor for suicidal ideation and suicide attempts among both medical and psychiatric patient populations. Hopelessness represents an independent dimension that is also associated with suicide risk. Demoralization can be useful in the early detection of suicidal ideation and suicidal behaviour in individuals who do not meet criteria for a clinical diagnosis of depression.
Strength and weaknesses:
The limitations of the study include inclusion of articles with a cross-sectional study design and small sample sizes. There was heterogeneity in the measurement of both demoralization and suicidality, which may lead to classification bias. In addition, the authors excluded articles in non-English languages, and most studies focused on SI and SA rather than suicides.
C-L psychiatrists are uniquely positioned to assess the extent of demoralization in patients with somatic illness. Understanding that demoralization, irrespective of a clinical diagnosis of major depression, can be a risk factor for suicidal ideation and suicidal behaviour can inform more meaningful treatment planning and suicide risk management.