Department of Psychiatry, 24998NYU Winthrop Hospital, NYU Langone Health, New York, NY, USA.
NYU Transplant Institute, 12297NYU Langone Health, New York, NY, USA.
Prog Transplant. 2021 Mar;31(1):88-90. doi: 10.1177/1526924820978602. Epub 2020 Dec 21.
Living with end stage organ failure and transplantation has implications for physiological, psychological, and social well-being. The development of anxiety or depressive disorders are common with demoralization, another psychological syndrome, a topic of interest in psychiatry. To feel demoralized is to lose hope, courage, or confidence, which upsets normal functioning. While depression may co-exist with demoralization, they are 2 distinct entities, with the former characterized by an inability to experience pleasure and the latter characterized by helplessness and avoidance coping. In an effort to more adequately address the psychological stress in organ transplant patients, it is important to distinguish between demoralization and depression. Demoralization has prognostic implications such as negative disease outcomes such as treatment nonadherence and an increase risk of suicide. Medication for depression is not effective for demoralization syndrome. Therapeutic interventions include cognitive behavioral techniques that focus on exploration of attitudes toward hope and meaning in life.
患有终末期器官衰竭和接受器官移植会对生理、心理和社会健康产生影响。焦虑或抑郁障碍的发展伴随着道德低落，这是一种精神科感兴趣的心理综合征。感到道德低落意味着失去希望、勇气或信心，这会打乱正常的功能。虽然抑郁症可能与道德低落同时存在，但它们是两种不同的实体，前者的特征是无法体验快乐，后者的特征是无助和回避应对。为了更充分地解决器官移植患者的心理压力，区分道德低落和抑郁症很重要。道德低落具有预后意义，例如治疗不依从和自杀风险增加等负面疾病结局。治疗抑郁症的药物对道德低落综合征无效。治疗干预包括认知行为技术，重点是探索对希望和生活意义的态度。
