title: Grief, depression, and the DSM-5.
abstract: Based on a review of the best available evidence and the importance of providing clinicians an opportunity to ensure that patients and their families receive the appropriate diagnosis and the correct intervention without necessarily being constrained by a somewhat arbitrary 2-month period of time, the DSM-5 Task Force recommended eliminating the "bereavement exclusion" (BE) from the diagnosis of major depressive disorder. This article reviews the initial rationale for creating a BE in DSM-III, reasons for not carrying the BE into DSM-5, and sources of continued controversy. The authors argue that removing the BE does not "medicalize" or "pathologize" grief, "stigmatize" bereaved persons, imply that grief morphs into depression after 2 weeks, place any time limit on grieving, or imply that antidepressant medications should be prescribed. Rather, eliminating the BE opens the door to the same careful attention that any person suffering from major depressive disorder deserves and allows the clinician to provide appropriate education, support, hope, care, and treatment.
authors.affiliation: ZISOOK and IGLEWICZ: University of California, San Diego, Veterans Affairs San Diego Healthcare System, and Veterans Medical and Research Foundation, La Jolla, CA; PIES: SUNY Upstate Medical University, Syracuse, NY, and Tufts University School of Medicine, Boston.
authors.forename: Sidney
authors.initials: S
authors.lastname: Zisook
authors.forename: Ronald
authors.initials: R
authors.lastname: Pies
authors.forename: Alana
authors.initials: A
authors.lastname: Iglewicz
mesh_terms: D001601:Bereavement; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006117:Grief; D006801:Humans; D012720:Severity of Illness Index; D009626:Terminology as Topic; D013997:Time Factors