Unresolved grief of 25 years duration exacerbated by multiple subsequent losses

A case report is presented in which there was a pathological grief reaction of 25 years duration that was not identified during many psychiatric hospitalizations. The case illustrates some of the situational and personality factors that can contribute to the failure to resolve grief, theoretically for an indefinite period of time. It also illustrates what a confusing clinical picture can be presented in a pathological grief reaction unless the impact of significant losses has been thoroughly evaluated. Finally, the manner in which this patient attempts to resolve his grief is discussed. Further research is needed to define the manifestations of bereavement as a clinical entity, to identify factors predisposing individuals to a pathological outcome, and to specify the various ways by which people come to accept a loss.