Prolonged Grief

Where to After Diagnostic and Statistical Manual of Mental Disorders, 5th Edition?

Richard A. Bryant

Disclosures

Curr Opin Psychiatry. 2014;27(1):21-26. 

In This Article

The Evidence for the Diagnosis

Many studies have supported the proposal that persistent yearning is a core symptom of the condition.[2–4] This pattern has also been validated in bereaved children.[5,6] A range of large-scale studies suggest that the rates of prolonged grief in bereaved cohorts is approximately 10%,[7] although the rates tend to be higher following violent or traumatic deaths, or the death of a child.[8–10] Population prevalence rates of prolonged grief are between 2.4 and 4.8%.[11,12] A range of factor analytic studies have indicated that prolonged grief is distinct from anxiety and depression in bereaved samples.[13–15] Importantly, it has been shown the symptoms of prolonged grief contribute uniquely to a range of problems, including psychological (depression, suicidality, substance abuse), unhealthy behaviors (tobacco use), medical conditions (elevated cancer rates, cardiovascular disorder, and blood pressure), and functional capacity.[16–18] The central symptoms of prolonged grief have also been documented across different cultures.[11,19,20] There are also distinct treatment implications of the proposed diagnosis. Whereas antidepressant medication can alleviate bereavement-related depression, it does not have the same efficacy on grief symptoms;[21] in contrast, there are two well controlled trials demonstrating that cognitive behavior therapy for prolonged grief is effective in alleviating symptoms in the majority of cases.[22,23]

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