The spectrum of grief: identification and management

Loss is a common human experience, and grief is frequently seen in a physician's office. Grief occurs not only after a death, but also during chronic or serious illness, infertility, divorce, job changes, surgery, rape, and so forth. Some patients somatize distress, presenting with physical symptoms rather than acknowledging their grief. Bereavement increases the risk of both psychiatric and physical disease and can exacerbate pre-existing illness. In the majority, grief resolves normally, but in some the process becomes morbid. The family physician is in a unique position to identify, educate, assess, and intervene with the grieving patient and his family.