title: Complicated grief and related bereavement issues for DSM-5.
abstract: Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally, grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence, some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This article focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders.
authors.affiliation: Columbia University School of Social Work, New York, New York, USA. ks2394@columbia.edu
authors.forename: M Katherine
authors.initials: MK
authors.lastname: Shear
authors.forename: Naomi
authors.initials: N
authors.lastname: Simon
authors.forename: Melanie
authors.initials: M
authors.lastname: Wall
authors.forename: Sidney
authors.initials: S
authors.lastname: Zisook
authors.forename: Robert
authors.initials: R
authors.lastname: Neimeyer
authors.forename: Naihua
authors.initials: N
authors.lastname: Duan
authors.forename: Charles
authors.initials: C
authors.lastname: Reynolds
authors.forename: Barry
authors.initials: B
authors.lastname: Lebowitz
authors.forename: Sharon
authors.initials: S
authors.lastname: Sung
authors.forename: Angela
authors.initials: A
authors.lastname: Ghesquiere
authors.forename: Bonnie
authors.initials: B
authors.lastname: Gorscak
authors.forename: Paula
authors.initials: P
authors.lastname: Clayton
authors.forename: Masaya
authors.initials: M
authors.lastname: Ito
authors.forename: Satomi
authors.initials: S
authors.lastname: Nakajima
authors.forename: Takako
authors.initials: T
authors.lastname: Konishi
authors.forename: Nadine
authors.initials: N
authors.lastname: Melhem
authors.forename: Kathleen
authors.initials: K
authors.lastname: Meert
authors.forename: Miriam
authors.initials: M
authors.lastname: Schiff
authors.forename: Mary-Frances
authors.initials: MF
authors.lastname: O'Connor
authors.forename: Michael
authors.initials: M
authors.lastname: First
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.forename: James
authors.initials: J
authors.lastname: Bolton
authors.forename: Natalia
authors.initials: N
authors.lastname: Skritskaya
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Mancini
authors.forename: Aparna
authors.initials: A
authors.lastname: Keshaviah
mesh_terms: D000275:Adjustment Disorders / Q000175:diagnosis* / Q000523:psychology; D001601:Bereavement; D002908:Chronic Disease; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006117:Grief; D006801:Humans; D012307:Risk Factors