Clinical judgement versus self-rating of demoralization in outpatients with a substance-use disorder: A cross-sectional study

Purpose: To investigate the ability of case managers, working in ambulatory treatment settings specialized in addiction care, to clinically judge demoralization in substance-dependent patients. Design and Methods: In a cross-sectional study, clinical judgments of case managers were compared with the patients' scores on the Demoralization Scale, by calculating the sensitivity and specificity scores. Findings: Case managers identified demoralization in 85% of the cases (sensitivity), the specificity of 62% suggests that demoralization was overestimated by case managers. Practice Implications: Demoralization is a frequently occurring phenomenon in patients. Methods should be developed that allow professionals and patients to identify demoralization collaboratively, and to develop tailored interventions to prevent demoralization and its negative consequences.