Validity of the Bereavement Exclusion Criterion for the Diagnosis of Major Depressive Episode

Overview

Journal World Psychiatry

Specialty Psychiatry

Date 2008 Feb 1

PMID 18235867

Citations 19

Authors

Sidney Zisook

Katherine Shear

Kenneth S Kendler

Affiliations

Soon will be listed here.

Abstract

Since the publication of DSM-III in 1980, the official position of American psychiatry has been that the presence of bereavement is an exclusion criterion for the diagnosis of a major depressive episode (MDE). However, the empirical validity of this exclusion has not been well established. As DSM-V is now being planned, it is timely to reexamine the bereavement exclusion, particularly in the light of new evidence since the last reviews of this subject. This paper evaluates the relative validity of two competing hypotheses: 1) the bereavement exclusion for the diagnosis of MDE is not valid because, using validating criteria, bereavement related depression (BRD) within the first two months after the death of a loved one resembles non-bereavement related depression (SMD); 2) the bereavement exclusion for the diagnosis of MDD is valid because, using validating criteria, BRD within the first two months after the death of a loved one does not resemble SMD. The prevailing evidence more strongly supports Hypothesis 1 than Hypothesis 2. Thus, the bereavement exclusion for the diagnosis of MDE may no longer be justified.

Citing Articles

Elucidating Role of Reactive Oxygen Species (ROS) in Cisplatin Chemotherapy: A Focus on Molecular Pathways and Possible Therapeutic Strategies.

Mirzaei S, Hushmandi K, Zabolian A, Saleki H, Torabi S, Ranjbar A Molecules. 2021; 26(8).

PMID: 33921908 PMC: 8073650. DOI: 10.3390/molecules26082382.

Distinguishing Bereavement from Depression in DSM-5: Evidence from Longitudinal Epidemiologic Surveys.

Paksarian D, Mojtabai R Psychiatr Ann. 2015; 43(6):276-282.

PMID: 26229212 PMC: 4517840. DOI: 10.3928/00485713-20130605-08.

Impact of a Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial.

Rosenbaum J, Smith J, Yan Y, Abram N, Jeffe D Death Stud. 2014; 39(1-5):191-200.

PMID: 25530502 PMC: 4382412. DOI: 10.1080/07481187.2014.946628.

Bereavement: course, consequences, and care.

Zisook S, Iglewicz A, Avanzino J, Maglione J, Glorioso D, Zetumer S Curr Psychiatry Rep. 2014; 16(10):482.

PMID: 25135781 DOI: 10.1007/s11920-014-0482-8.

The removal of the bereavement exclusion in the DSM-5: exploring the evidence.

Iglewicz A, Seay K, Zetumer S, Zisook S Curr Psychiatry Rep. 2013; 15(11):413.

PMID: 24136623 DOI: 10.1007/s11920-013-0413-0.

References

Dunn A, Swiergiel A, de Beaurepaire R . Cytokines as mediators of depression: what can we learn from animal studies?. Neurosci Biobehav Rev. 2005; 29(4-5):891-909. DOI: 10.1016/j.neubiorev.2005.03.023. View

Zisook S, Shuchter S . Major Depression Associated With Widowhood. Am J Geriatr Psychiatry. 2017; 1(4):316-326. DOI: 10.1097/00019442-199300140-00006. View

Shuchter S, Zisook S, Kirkorowicz C, Risch C . The dexamethasone suppression test in acute grief. Am J Psychiatry. 1986; 143(7):879-81. DOI: 10.1176/ajp.143.7.879. View

Judd L, Akiskal H, Zeller P, Paulus M, Leon A, Maser J . Psychosocial disability during the long-term course of unipolar major depressive disorder. Arch Gen Psychiatry. 2000; 57(4):375-80. DOI: 10.1001/archpsyc.57.4.375. View

Weller R, Weller E, Fristad M, Bowes J . Depression in recently bereaved prepubertal children. Am J Psychiatry. 1991; 148(11):1536-40. DOI: 10.1176/ajp.148.11.1536. View

Nemeroff C . The neurobiology of depression. Sci Am. 1998; 278(6):42-9. DOI: 10.1038/scientificamerican0698-42. View

Robins E, Guze S . Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry. 1970; 126(7):983-7. DOI: 10.1176/ajp.126.7.983. View

Gallagher D, Breckenridge J, Thompson L, Peterson J . Effects of bereavement on indicators of mental health in elderly widows and widowers. J Gerontol. 1983; 38(5):565-71. DOI: 10.1093/geronj/38.5.565. View

Kendler K, Thornton L, Gardner C . Stressful life events and previous episodes in the etiology of major depression in women: an evaluation of the "kindling" hypothesis. Am J Psychiatry. 2000; 157(8):1243-51. DOI: 10.1176/appi.ajp.157.8.1243. View

10.

Gilewski M, Farberow N, Gallagher D, Thompson L . Interaction of depression and bereavement on mental health in the elderly. Psychol Aging. 1991; 6(1):67-75. DOI: 10.1037//0882-7974.6.1.67. View

11.

Karam E . The nosological status of bereavement-related depressions. Br J Psychiatry. 1994; 165(1):48-52. DOI: 10.1192/bjp.165.1.48. View

12.

Zisook S, Shuchter S, Pedrelli P, Sable J, Deaciuc S . Bupropion sustained release for bereavement: results of an open trial. J Clin Psychiatry. 2001; 62(4):227-30. DOI: 10.4088/jcp.v62n0403. View

13.

Kendler K . The nosologic validity of paranoia (simple delusional disorder). A review. Arch Gen Psychiatry. 1980; 37(6):699-706. DOI: 10.1001/archpsyc.1980.01780190097012. View

14.

Byrne G, Raphael B . Depressive symptoms and depressive episodes in recently widowed older men. Int Psychogeriatr. 1999; 11(1):67-74. DOI: 10.1017/s1041610299005591. View

15.

Clayton P, Halikas J, Maurice W . The depression of widowhood. Br J Psychiatry. 1972; 120(554):71-7. DOI: 10.1192/bjp.120.554.71. View

16.

Brent D, Peters M, Weller E . Resolved: several weeks of depressive symptoms after exposure to a friend's suicide is "major depressive disorder". J Am Acad Child Adolesc Psychiatry. 1994; 33(4):582-7. DOI: 10.1097/00004583-199405000-00017. View

17.

Judd L, Akiskal H, Maser J, Zeller P, Endicott J, Coryell W . A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Arch Gen Psychiatry. 1998; 55(8):694-700. DOI: 10.1001/archpsyc.55.8.694. View

18.

Lewinsohn P, Hoberman H, Rosenbaum M . A prospective study of risk factors for unipolar depression. J Abnorm Psychol. 1988; 97(3):251-64. DOI: 10.1037//0021-843x.97.3.251. View

19.

Reynolds 3rd C, Kupfer D . Sleep research in affective illness: state of the art circa 1987. Sleep. 1987; 10(3):199-215. DOI: 10.1093/sleep/10.3.199. View

20.

Harlow S, Goldberg E, Comstock G . A longitudinal study of risk factors for depressive symptomatology in elderly widowed and married women. Am J Epidemiol. 1991; 134(5):526-38. DOI: 10.1093/oxfordjournals.aje.a116125. View