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As emotional distress is often seen as an understandable reaction to a severe or lifethreatening illness, clinicians are reluctant to make a diagnosis of depression and resort to alternative diagnoses such as adjustment disorder (AD) or demoralisation. This paper introduces these concepts and critically examines their clinical utility. It concludes that neither AD nor demoralisation can be clearly distinguished from depression on variables such as clinical symptoms, outcome or treatmentdoi:10.7861/clinmedicine.7-5-478 pmid:17990716 fatcat:sqnk4og5ojbmxcp4bkojlapzdy