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PTSD following bereavement

S Zisook1, Y Chentsova-Dutton, S R Shuchter

  • 1University of California, San Diego, La Jolla 92093-0603, USA. szisook@ucsd.edu

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists
|February 13, 1999
PubMed
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Post-Traumatic Stress Disorder (PTSD) may occur after bereavement, challenging previous diagnostic criteria. This study found PTSD in bereaved individuals, particularly after unnatural deaths, highlighting the need to re-examine diagnostic stressors.

Area of Science:

  • Psychiatry
  • Psychology
  • Epidemiology

Background:

  • Historically, Post-Traumatic Stress Disorder (PTSD) diagnosis was limited to catastrophic, extraordinary stressors, making it rare in non-military populations.
  • Recent epidemiological surveys and the DSM-IV criteria suggest PTSD may be more prevalent and linked to a broader range of stressors.
  • Bereavement has not traditionally been recognized as a stressor capable of causing PTSD.

Purpose of the Study:

  • To assess the prevalence, chronicity, comorbidity, and consequences of PTSD among newly bereaved individuals.
  • To investigate whether bereavement, particularly under different circumstances of death, can be a stressor for PTSD.
  • To examine the adequacy of the "A" criterion in the DSM-IV for diagnosing PTSD in the context of bereavement.

Main Methods:

Related Experiment Videos

  • A study involving 350 newly bereaved widows and widowers.
  • Assessment for PTSD using questionnaire items approximating DSM-IV criteria.
  • Data collected at 2 months post-bereavement, categorizing deaths by chronic illness, unexpected, or unnatural causes (suicide/accident).

Main Results:

  • At 2 months post-bereavement, 10% of those whose spouses died from chronic illness and 9% from unexpected death met PTSD criteria.
  • A significantly higher prevalence of 36% PTSD was observed in those whose spouses died from unnatural causes (suicide or accident).
  • PTSD symptoms were chronic in at least 40% of subjects, frequently comorbid with depression, and associated with substantial morbidity.

Conclusions:

  • The findings suggest that PTSD can occur following bereavement, challenging the exclusion of such stressors from diagnostic criteria.
  • The results imply that PTSD may arise from other stressors not currently recognized by official diagnostic systems.
  • There is a need for further examination and potential revision of the "A" criterion for PTSD diagnosis.