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Uncomplicated bereavement

S Zisook1, S R Shuchter

  • 1Department of Psychiatry, University of California, San Diego School of Medicine.

The Journal of Clinical Psychiatry
|October 1, 1993
PubMed
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Bereaved individuals experiencing a full depressive syndrome soon after spousal loss often have prolonged symptoms and significant morbidity. Major depressive episodes should be excluded from uncomplicated bereavement definitions.

Area of Science:

  • Psychiatry
  • Psychology
  • Grief Studies

Background:

  • Distinguishing between major depression and depressive symptoms in uncomplicated bereavement is clinically significant.
  • Bereavement can trigger depressive syndromes that may be difficult to differentiate from major depressive disorder.
  • Understanding the long-term course of depressive symptoms following spousal loss is crucial for accurate diagnosis and treatment.

Purpose of the Study:

  • To evaluate the validity of differentiating between uncomplicated bereavement and major depression.
  • To examine the course, symptoms, and impairment of depressive episodes in bereaved individuals.
  • To determine if early depressive syndromes in widowhood predict later major depression.

Main Methods:

  • A cohort of 259 widows and widowers were assessed using the San Diego Widowhood Questionnaire at 2, 13, and 25 months post-loss.

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  • Depressive status was determined based on Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) criteria.
  • The study followed the trajectory of depressive symptoms and associated clinical features over time.

    • Main Results:

    • At 2 months, 23% of subjects met criteria for a major depressive syndrome.
    • This early depressive group showed higher rates of prior depression, suicidal ideation, and antidepressant use.
    • Compared to non-depressed peers, the early depressed group had a greater likelihood of experiencing major depression at 1 and 2 years post-loss.

    Conclusions:

    • A full depressive syndrome emerging early in bereavement is often prolonged and associated with significant morbidity.
    • Individuals experiencing major depressive episodes during bereavement exhibit distinct clinical features and prognoses.
    • Future definitions of uncomplicated bereavement should exclude cases presenting with major depressive episodes.