Background Demoralisation syndrome (DS) has been advanced as a construct that features hopelessness, meaninglessness, and existential distress. Demoralisation and DS have predominantly been considered secondary only to illness; hence there is scant research on demoralisation or DS in populations affected by extreme environmental stress. Aims The current study aimed to determine the prevalence of demoralisation, its predictors, and the relevance of DS in a community-based forced-migrant population. Method A convenience sample of 131 adult asylum-seekers (n = 98) and refugees (n = 33) without recognised mental disorders in Melbourne, Australia, were assessed cross-sectionally on posttraumatic stress, anxiety, depression, post-migration stress, and demoralisation. Socio-demographic data were analysed with relevant clinical data. Predictive aims were investigated using bivariate statistical tests and exploratory aims were investigated using correlational and linear regression analyses. Results Seventy nine percent of the sample met criteria for demoralisation (asylum-seekers = 83%; refugees = 66%), with asylum-seekers being 2.55 (95% C.I. = 1.03-6.32, Z = 2.03, p =.04) times more likely to be demoralised than refugees. No relationship between demoralisation and time in the refugee determination process emerged. The regression model explained 47.5% of variance in demoralisation scores for the total sample F(9,111) = 13.07, p <.0001, with MDD and anxiety score making unique significant contributions. Conclusions Demoralisation was widespread through the asylum-seeker and refugee population and its prevalence was attributable to a range of social and psychiatric factors. However, DS had little explanatory power for psychiatric morbidity, which was more suggestive of a pan-distress symptom complex. © 2015 Elsevier Inc. All rights reserved.

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anxiety helplessness depression social psychology refugee anxiety disorder Australia psychological aspect demography community care human clinical assessment Refugees comorbidity middle aged population group social isolation Population Groups controlled study checklist clinical study mini international neuropsychiatric interview Residence Characteristics Cross-Sectional Studies mental disease Surveys and Questionnaires asylum seeker social status cross-sectional study psychology Humans male demoralisation syndrome Psychiatric Epidemiology Research Interview Demoralisation Scale female Post Migration Living Difficulties Checklist post migration stress Harvard Trauma Questionnaire questionnaire refugee camp emotional disorder prevalence Article suicidal behavior employment status adult major clinical study environmental stress posttraumatic stress disorder distress syndrome Stress Disorders, Post-Traumatic demoralization mental disease assessment Hopkins Symptom Checklist 25 hopelessness Adjustment Disorders major depression time suicidal ideation