Question: Normal verses Complicated Bereavement

  • Patient or Population: Women who have had still births and develop self-mutilating and suicidal behaviors
  • Intervention or Indicator: diagnostic test: taking adequate history to differentiate between normal and complicated bereavement
  • Comparison or Control: samples of people who have had various grief/bereavement presentations
  • Outcome:

2: J Palliat Med. 2006 Oct;9(5):1188-203.

Full Text

Update on bereavement research: evidence-based guidelines for the diagnosis and treatment of complicated bereavement.

Zhang B, El-Jawahri A, Prigerson HG.

Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School Center for Palliative Care, Dana-Farber Cancer Institute, Psycho-oncology and Palliative Care Research, Boston, Massachusetts 02115, USA.

The past decade has witnessed considerable growth in the evidence-base from which clinical recommendations for bereavement care can be made. Research now provides guidance to assist clinicians in: a) recognizing differences between complicated and uncomplicated bereavement reactions, b) identifying risk factors that may make certain individuals more vulnerable to bereavement-related complications, c) appreciating and monitoring for potential adverse outcomes associated with bereavement and d) taking actions to prevent or minimize maladjustment to the loss. In this article we distinguish between the course of normal grief and abnormally prolonged, or complicated grief; clarify distinctions between Complicated Grief Disorder and other mental disorders secondary to bereavement; review outcomes associated with Complicated Grief Disorder; describe research on resilience in bereavement; present findings on stigmatization and the use of mental health services among recently bereaved persons; and summarize where the field is with respect to establishing the efficacy and effectiveness of bereavement interventions. Promising new psychotherapies for Complicated Grief Disorder have shown clinical efficacy. Nevertheless, further research is needed to enhance the detection of vulnerable bereaved persons, to promote resilience following significant interpersonal loss, and to tailor interventions to address the attachment issues that lie at the heart of this disorder.

PMID: 17040157 [PubMed - indexed for MEDLINE]