A case for establishing complicated grief as a distinct mental disorder in DSM-V

    • Abstract

      In this paper, we contend that complicated grief (CG) constitutes a distinct psychopathological diagnostic entity and thus warrants a place in standardized psychiatric diagnostic taxonomies. CG is characterized by a unique pattern of symptoms following bereavement that are typically slow to resolve and can persist for years if left untreated. This paper will demonstrate that existing diagnoses are not sufficient, as the phenomenology, risk factors, clinical correlates, course, and outcomes for CG are distinct from those of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and adjustment disorder (AD). It is argued that the establishment of CG as a diagnostic entity is essential because its symptoms are associated with enduring mental and physical health morbidity and require specifically designed clinical interventions. We conduct a critical review of all published evidence on this topic to date, demonstrating that the advantages of standardizing the diagnostic criteria of CG outweigh the disadvantages. In addition, recommendations for future lines of research are made. This paper concludes that CG must be established in the current nosology to address the needs of individuals who are significantly suffering and impaired by this disorder.

  • Wendy G. Lichtenthala
  • Dean G. Cruessa
  • Holly G. Prigersonbc
  • a Department of Psychology, 3720 Walnut Street, University of Pennsylvania, Philadelphia, PA, 19104, USA
  • b Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
  • c Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA
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  • Grief
  • Diagnosis
  • Diagnostic and Statistical Manual
  • Taxonomies
  • Mental disorders
Corresponding author. Tel.: +1 215 620 3220; fax: +1 215 898 7301.