The relationship between demoralization and quality of life in breast cancer patients

Introduction: Demoralization is a frequent psychological response to cancer. However, the impact of demoralization on quality of life in cancer patients has been virtually neglected by the literature. The aim of this study was to examine the relationship between demoralization and quality of life in cancer patients. Methods: A sample of 142 women with a diagnosis of breast cancer (mean age 53.4 ± 10.8 years; 75.4% with primitive cancer and 24.6% with metastatic cancer) underwent the demoralization section of the Structured Interview according to the Diagnostic Criteria for Psychosomatic Research (DCPR) and completed the following self-report questionnaires: Demoralization Scale (DS), Psychiatric Epidemiology Research Interview-Demoralization (PERI-D)., Subjective Incompetence Scale I and II (SIS-I and SIS-II), and the Short Form-36 Health Survey (SF-36). Results: Demoralization according to the DCPR was found in 24.6% of participants and was significantly associated with lower scores on all the SF-36 scales, except for “physical functioning” and “role limitations due to physical health”. The DS, PERI-D, SIS-I, and SIS-II were negatively correlated with all the SF-36 scales: higher demoralization scores corresponded to a worse quality of life. Conclusions: Demoralization seems to play a detrimental role on satisfaction for one’s own quality of life in breast cancer patients. It is also possible that a diminished quality of life may increase the vulnerability to demoralization. The use of psychotherapeutic treatments for demoralization could enhance quality of life in patients with a diagnosis of cancer.