Young Women With Pancreatic Cancer: A High-Risk Group for Demoralization

Demoralization is a maladaptive coping response to stressful situations, characterized by thoughts of hopelessness, helplessness, and loss of meaning and purpose. Demoralization is clinically measurable using the Demoralization Scale 2 (DS-II). Pancreatic cancer (PC) patients, who carry a notoriously poor prognosis, are hypothesized to be at higher risk of demoralization.

This study uses the DS-II to gauge the impact of demoralization in PC patients compared to a heterogenous cancer population and establish its relation to depression.

Patients completed the DS-II, PHQ-9, and a demographic survey. The mean DS-II score of PC patients was compared with that of a previously published heterogenous cancer cohort reported by Ignatius et al. using a one-sample t-test. The univariable association between DS-II scores and PHQ-9 scores was examined using linear regression models.

Of the 206 patients enrolled in the study, 47% were women and the mean age was 67 ± 10 years. The mean DS-II total score was 4.9 ± 5.2 points, significantly lower than the mean of 10.8 ± 8.0 previously reported by Ignatius and De La Garza II in a psychiatric oncology cohort (p < 0.001). There was no significant difference in demoralization scores across disease stages (p = 0.8). DS-II scores in univariable models were associated with depression (β = 0.79, p < 0.001), age (β = -0.09, p = 0.008), and women (p = 0.002).

Demoralization in this cohort of patients with PC was lower than that reported by Ignatius et al., although differences in recruitment settings and patient characteristics limit direct comparisons. Though disease stage did not impact demoralization scores in PC, our study found demoralization was strongly associated with concurrent depression, young age, and women. Understanding the risk factors associated with demoralization in PC can help enhance the quality of psychosocial care in oncology.