Tipping Point: Pathogenic Stress and the Biopolitics of Euthanasia DOI
Charles S. Love

The Linacre Quarterly, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 18, 2024

Hopelessness and demoralization following a terminal diagnosis can affect the capacity for self-governance. Such dispositions increase allostatic load—the cumulative burden of stress anxiety—resulting in neurophysiologic decline that impair autonomy influence desire to end one's life deliberately. An overload is characterized by inability autoregulate associated with pathological changes hypothalamic–pituitary–adrenal axis hippocampus. These raise concerns about reliability concepts extremis, potentially undermining arguments are used justify voluntary euthanasia medically assisted death. Studies have depression hopelessness suicidal ideation general population. However, fewer studies examined how patients without history or may suddenly contemplate act when facing prognosis. This paper will argue an help explain spectrum physical psychological comorbidities onset illness decision hasten Data show disease wishing death typically exhibit lower rates clinical depression, higher demoralization, greater likelihood rational suicide. differences indicate patient population different. Changes autonomous decision-making secondary alterations brain offer explanation. been shown dysregulate executive control functions, specifically intentionality voluntariness. Clinical evidence also indicates spirituality hopefulness manage load during palliative stages so better process end-of-life decisions. Based on these data, this further jurisdictions offering morally compelled make mental spiritual counseling available seeking course action.

Language: Английский

Key psychosocial issues in medical care DOI
Giovanni A. Fava, Chiara Patierno,

Nicoletta Sonino

et al.

Acta Psychiatrica Scandinavica, Journal Year: 2024, Volume and Issue: 149(5), P. 368 - 377

Published: Feb. 1, 2024

Abstract Objective The aim of this review is to illustrate an innovative framework for assessing the psychosocial aspects medical disorders within biopsychosocial model. It based on clinimetrics, science clinical measurements. may overcome limitations DSM‐5 in identifying highly individualized responses at experiential, behavioral, and interpersonal levels. Method A critical clinimetric formulations model setting disease was performed. References were identified through searches from PubMed English articles human subjects published January 1982 October 2023. Results Clinimetric methods classification have been found deserve special attention four major areas: allostatic load (the cumulative cost fluctuating heightened neural or neuroendocrine environmental stressors); health attitudes behavior; persistent somatization; demoralization irritable mood. This type assessment, integrated with traditional psychiatric nosography, disclose pathophysiological links provide characterizations that demarcate prognostic therapeutic differences among patients who otherwise seem deceptively similar because they same diagnosis. be value a number situations, such as: high level disability compromised quality life relation what expected by status; delayed partial recovery; insufficient participation self‐management and/or rehabilitation; failure resume healthy role after convalescence; unhealthy lifestyle; attendance facilities disproportionate detectable disease; lack treatment adherence; illness denial. Conclusions approach assessment key variables lead unique individual profiles, take into account both biology biography. offer new opportunities integrating perspectives.

Language: Английский

Citations

7
Distinguishing and treating demoralization syndrome in cancer: A review DOI Open Access
Maurizio Fava,

Emily Sorg,

Jamie M. Jacobs

et al.

General Hospital Psychiatry, Journal Year: 2023, Volume and Issue: 85, P. 185 - 190

Published: Oct. 10, 2023

Language: Английский

Citations

15
Clinical Use of Staging in Psychiatry DOI
Giovanni A. Fava

Psychotherapy and Psychosomatics, Journal Year: 2024, Volume and Issue: 93(3), P. 143 - 150

Published: Jan. 1, 2024

Language: Английский

Citations

6
Illness Denial in Medical Disorders: A Systematic Review DOI
Chiara Patierno, Giovanni A. Fava, Danilo Carrozzino

et al.

Psychotherapy and Psychosomatics, Journal Year: 2023, Volume and Issue: 92(4), P. 211 - 226

Published: Jan. 1, 2023

Introduction: Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease need treatment. Objective: This systematic review was performed clarify clinical role and manifestations illness denial, its impact on health attitudes behavior, as well short- long-term outcomes in with disorders. Methods: The search according Preferred Reporting Items for Systematic Review Meta-Analysis (PRISMA) guidelines conducted PubMed, Scopus, Web Science. Results: initial yielded a total 14,098 articles; 176 studies met criteria inclusion. appeared be relatively common condition affecting wide spectrum behavior. In some cases, it may help person cope various stages other situations, determine delay seeking treatment, impaired adherence, reduced self-management, leading adverse outcomes. Diagnostic Criteria Psychosomatic Research (DCPR) were found set useful threshold condition. An important distinction can also made based DCPR which require assessment whether patient has been provided an adequate appraisal situation. Conclusions: indicates that disorders experience express many forms varying degrees severity. findings suggest multidimensional provide challenging insights into management

Language: Английский

Citations

12
Determinants of Demoralization Syndrome and Social Support Among Patients with Breast Cancer: A Cross-Sectional Study DOI Creative Commons
Yang Li,

Ling-Xia Song,

Lin Zhang

et al.

Journal of Multidisciplinary Healthcare, Journal Year: 2025, Volume and Issue: Volume 18, P. 369 - 379

Published: Jan. 1, 2025

Objective: This study aimed to assess the determinants of demoralization syndrome among patients with breast cancer (BC) in southwestern region China.Methods: investigation constituted a single-center cross-sectional which 176 BC were surveyed through questionnaire covering current status and social support.Results: Majority developed moderate-to-severe levels demoralization.The degree was complex influenced by variety factors.Among BC, demographic variables such as age, education level, residential address, monthly income, occupation, receipt chemotherapy main influencing factors (P < 0.05), whereas children, surgical methods not 0.05).Additionally, all reported receiving support exceeding moderate levels, no statistically significant difference data observed those reporting heightened > 0.05). Conclusion:There are many BC.Nursing interventions play pivotal role minimizing BC.We should pay more attention commitment level.Positive communication patients, involving attentive listening, guidance encouragement, is essential for providing effective psychological care support, fostering trust between healthcare providers patients.

Language: Английский

Citations

0
Existential distress in advanced cancer: A cohort study DOI Creative Commons
R Philipp, Charlotte Walbaum, Uwe Koch

et al.

General Hospital Psychiatry, Journal Year: 2025, Volume and Issue: 94, P. 184 - 191

Published: March 6, 2025

Language: Английский

Citations

0
The role of interviewing in endocrine practice DOI Creative Commons

Nicoletta Sonino,

Giovanni A. Fava, David C. Aron

et al.

Journal of Endocrinological Investigation, Journal Year: 2025, Volume and Issue: unknown

Published: March 29, 2025

Language: Английский

Citations

0
Psychedelics for the treatment of end-of-life distress in patients with a life-threatening disease DOI
Stephan Tap,

Tijmen Bostoen,

Joost J. Breeksema

et al.

International review of neurobiology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

Citations

0
Modeling of demoralization in breast cancer DOI Creative Commons
John M. de Figueiredo, Robert Kohn, Joyce Y. Chung

et al.

Frontiers in Psychiatry, Journal Year: 2025, Volume and Issue: 16

Published: April 25, 2025

This study aimed at identifying correlates of demoralization in breast cancer. Information was obtained from outpatients with cancer the Oncology Clinic a university-affiliated hospital United States, using reliable and valid scales, participants' medical records on demographic social characteristics, location, type, stage cancer, whether it re-occurrence or first time diagnosed, type treatment, medications being used, history mental disorder, functional impairment, perceived stress, support, resilience, subjective incompetence, demoralization, depression. Demoralization measured Scale. Bivariable multivariable analyses were conducted as dependent variable. correlated positively depression, negatively months since diagnosed quality life. Forward stepwise regression without depression equation identified emotional wellbeing subscale life, impairment significant. After forced entry support mild ceased to be significant, leaving only moderate severe Perceived stress did not enter any models. Early detection co-occurrence are essential for promoting well-being patients Psychotherapy should focus strengthening modifiable negative countering positive correlates, preventing

Language: Английский

Citations

0
Patient Health Questionnaire-9: A clinimetric analysis DOI Creative Commons
Fiammetta Cosci, Kaj Sparle Christensen,

Sara Ceccatelli

et al.

Brazilian Journal of Psychiatry, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Objective: The Patient Health Questionnaire-9 (PHQ-9) is a widely used self-report measure of depression whose psychometric properties were found to be merely acceptable.Insufficient attention has been devoted its clinimetric validity, while clinical utility still debated, particularly for assessing severity.This the first study test PHQ-9 construct validity and based on principles.Methods: An online survey 3,398 participants was conducted.Item response theory models (Rasch Mokken analyses) assess determine utility.Results: Fit Rasch model achieved after adjusting sample size.Items 2, 4, 6, 9 over-discriminated, items 1, 5, 7 under-discriminated.Local dependency between 2 6 indicated.The not unidimensional.A Loevinger's coefficient 0.49 found, indicating an acceptable level scalability. Conclusion:The instrument with potential as overall index depression, mainly screening purposes.Substantial revision, in wording over-and under-discriminating items, needed.

Language: Английский

Citations

3