Demoralization is a complex clinical phenomenon which has raised a growing interest in clinical and research realms. The present systematic review of the literature aimed at (1) updating on demoralization prevalence in different populations, (2) identifying the instruments more largely used to assess demoralization, and (3) verifying whether new tools of assessment have been proposed. PubMed and Web of Science were searched from inception to April 2022. Search terms were: demoralization/demoralized/demoralizing/demoralised/demoralising. PRISMA guidelines were followed. GRADE rating system was used. A total of 188 papers were included. Demoralization appeared to be a distinctive psychological state common in medical, psychiatric, and non-clinical settings, thus not limited to life-threatening diseases. Diagnostic Criteria for Psychosomatic Research (DCPR) and Demoralization Scale (DS) are the most commonly used tools to assess it. DCPR allow to diagnose demoralization as a manifestation of dealing with chronic stress. DS captures dimensionally a psychological distress related to end of life. Demoralization is associated with clinical features encompassing allostatic overload, quality of life, wellbeing/euthymia. Implications on health outcomes and treatment are discussed. Demoralization warrants careful consideration in clinical contexts through valid assessment procedures. DCPR are recommended to diagnose it, DS can be helpful to capture clinical details.

士气低落是一种复杂的临床现象，引起了临床和研究领域越来越多的兴趣。目前对文献的系统审查旨在 (1) 更新不同人群士气低落的流行率，(2) 确定更多用于评估士气低落的工具，以及 (3) 验证是否已提出新的评估工具。从开始到 2022 年 4 月搜索了 PubMed 和 Web of Science。搜索词是：demoralization/demoralized/demoralizing/demoralised/demoralising。遵循 PRISMA 准则。使用 GRADE 评级系统。共收录论文 188 篇。士气低落似乎是一种独特的心理状态，在医学、精神病学和非临床环境中很常见，因此不仅限于危及生命的疾病。心身研究诊断标准 (DCPR) 和士气低落量表 (DS) 是最常用的评估工具。DCPR 允许将士气低落诊断为处理慢性压力的表现。DS 从维度上捕捉了与生命终结相关的心理困扰。士气低落与临床特征相关，包括静力过载、生活质量、幸福感/幸福感。讨论了对健康结果和治疗的影响。士气低落需要通过有效的评估程序在临床环境中仔细考虑。建议使用 DCPR 进行诊断，DS 有助于捕捉临床细节。DS 从维度上捕捉了与生命终结相关的心理困扰。士气低落与临床特征相关，包括静力过载、生活质量、幸福感/幸福感。讨论了对健康结果和治疗的影响。士气低落需要通过有效的评估程序在临床环境中仔细考虑。建议使用 DCPR 进行诊断，DS 有助于捕捉临床细节。DS 从维度上捕捉了与生命终结相关的心理困扰。士气低落与临床特征相关，包括静力过载、生活质量、幸福感/幸福感。讨论了对健康结果和治疗的影响。士气低落需要通过有效的评估程序在临床环境中仔细考虑。建议使用 DCPR 进行诊断，DS 有助于捕捉临床细节。