Diagnosing demoralization in consultation psychiatry

Demoralization, a normal response to adversity, is commonly seen in medical and surgical patients referred for psychiatric consultation. Demoralization should be distinguished from adjustment disorders and other pathological conditions--a process that would be facilitated if demoralization, like grief, were given a V code in DSM. Although the primary responsibility for treating demoralization rests with the patient's physician, the consulting psychiatrist must make an accurate diagnosis and begin the process of supportive psychotherapy.