The aim of this study was to assess the presence of demoralization and major depression in the setting of medical disease. 807 consecutive outpatients recruited from different medical settings (gastroenterology, cardiology, endocrinology and oncology) were assessed according to DSM-IV and DCPR criteria, using semistructured research interviews.

Demoralization was identified in 245 (30.4%) patients, while major depression was present in 135 (16.7%) patients. Even though there was a considerable overlap between the two diagnoses, 59 (43.7%) patients with major depression were not classified as demoralized, and 169 (69%) patients with demoralization did not satisfy the criteria for major depression.

The findings suggest a high prevalence of demoralization in the medically ill and the feasibility of a differentiation between demoralization and depression. Further research may determine whether demoralization, alone or in association with major depression, entails prognostic and clinical implications.


The team went on to discover that the common way that all bipolar drugs work is by their ability to deplete the chemical inositol trisphosphate, found in the nervous system. This common effect caused by three very different drugs is the core of how manic depressive drugs work and the team has now used this discovery to develop a system for testing new manic depression drugs. Using this system, the team has found two possible alternatives to the current drugs on the market lithium, valproic acid and carbamazepine. The novel drugs are based on valproic acid. They still work to deplete the chemical inositol trisphosphate but the team has eliminated harmful side effects. Initial tests on slime mould were later confirmed in the animal nervous system and are now ready to be extended to comprehensive trials. The team is the first group of scientists working in this field to use a slime mould to design better manic depression drugs.

Dr Williams said: "Testing new drugs on slime mould is possible because cells function in a very similar way, be they from a human or from a slime mould. If a drug acts on a basic part of a cell's function by, for example, inhibiting an enzyme, it should inhibit that enzyme in both human and slime mould cells. Working in slime mould is faster, easier and more reliable than the more complicated mammalian nerve cell."

"Although our system does not predict precisely how new drugs will impact on people - after all the brain is more complex than a single cell - we have made the first step in identifying new manic depression drugs and this has previously been impossible. This gives us some basis for believing that these new drugs could be useful and would warrant further testing. Testing the drug on slime mould initially acts as a reliable guide for scientists so for the first time we can screen drugs and identify better treatments for manic depression."