Consultation-Liaison Case Conference: Management of Demoralization in the Medical Setting

Demoralization has important implications for patients' health, but consultation-liaison psychiatrists may be less familiar with diagnosis and management due to limited inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. We present the case of a multivisceral transplant patient who experienced demoralization due to complications from her posttransplant course. We discuss the diagnosis of demoralization, including differential diagnoses to consider, followed by a discussion of management of demoralization in the inpatient setting using acceptance and commitment therapy. We then discuss the consultation-liaison psychiatrist's role in assisting with management of teams' counter-transference to difficult patient cases, including the possibility of teams experiencing their own demoralization.