de Figueiredo J M
Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
Compr Psychiatry. 1993 Sep-Oct;34(5):308-11. doi: 10.1016/0010-440x(93)90016-w.
Demoralization may be viewed as a combination of distress and subjective incompetence. The main problem in demoralization is the sense of incompetence experienced by the demoralized individual; this sense of incompetence results from uncertainty as to the appropriate direction of action. By contrast, the major difficulty in endogenomorphic depression is a decreased magnitude of motivation even when the appropriate direction of action is known. This distinction is important not only because demoralization appears to be a major public health problem, but also because subjective incompetence appears to influence the course and worsen the prognosis of both nonpsychiatric and psychiatric disorders.
士气低落可被视为痛苦与主观无能的结合。士气低落的主要问题在于士气低落者所体验到的无能感；这种无能感源于对适当行动方向的不确定性。相比之下，内源性抑郁症的主要困难在于，即使知道了适当的行动方向，动机强度仍会降低。这种区别很重要，不仅因为士气低落似乎是一个主要的公共卫生问题，还因为主观无能似乎会影响非精神疾病和精神疾病的病程并恶化其预后。
