Improved Diagnostic Criteria Needed for Individuals with Complicated Grief
New York, NY – To better identify and diagnose those suffering from debilitating grief after the death of a loved one, proposed diagnostic criteria need significant modifications, according to research published today in the American Journal of Psychiatry – the first study of its kind to study the performance of newly proposed criteria.
Researchers from Columbia University, and the Uniformed Services University of the Health Sciences (USU), in Bethesda, Md., studied the performance of diagnostic criteria for persistent complex bereavement disorder (PCBD), which was recently added as a condition for further study in the Diagnostic Statistical Manual of Mental Disorders, fifth edition (DSM-5). Also referred to as prolonged grief disorder or complicated grief, PCBD is associated with long-term intense distress and suffering. It affects about seven to 15 percent of those grieving the loss of a loved one, and is typically diagnosed when persistent and severe grief continue beyond six to 12 months after the death of a loved one, resulting in functional impairment.
To better assess these criteria, the researchers examined responses of study participants from the National Military Family Bereavement Study, which is examining the impact of military service member death on family members. Participants included surviving family members of military members who died, by all circumstances, since Sept. 11, 2001. Researchers found that the proposed DSM-5 criteria for PCBD accurately excluded nonclinical normative grief, but were not adequate to accurately identify clinically impairing cases of grief in this sample.
Based on their findings, the researchers suggest clinicians consider a PCBD diagnosis when patients exhibit prolonged distress and disability associated with the death of a loved one. Symptoms should also include persistent yearning or sorrow, or preoccupation with the deceased. While a number of additional symptoms may be present, study findings suggest that only one, rather than six, of twelve additional symptom criteria currently proposed by DSM-5 be required. The researchers also encourage clinicians to remain vigilant to suicidal thinking, which is prevalent in those with persistent and impairing grief.
Dr. Katherine Shear, Director of the Center for Complicated Grief, at Columbia University, and senior author of this paper said, “This study shows that complicated grief criteria accurately identify clinically impairing grief while those proposed in DSM-5 do not. These findings suggest that criteria for persistent complex bereavement disorder criteria need to be revised. For clinicians who work with bereaved populations, the study findings offer a simple approach to diagnosing individuals suffering from intense and debilitating grief, and we encourage them to become familiar with the evidence-based treatment for this condition.”
For more information, please contact:
Trudi Baldwin, Center for Complicated Grief
Please click here to see the study on the AJP website.
# # #
About the Center for Complicated Grief at Columbia University
The Center for Complicated Grief was established in 2013 in order to foster activities to improve the lives of people who suffer from complicated grief. The Center for Complicated Grief rests upon a foundation of more than two decades of research funded by the National Institute of Mental Health that produced a highly effective psychotherapy that has an average 70% response rate. The Center’s mission is to continue this work through a comprehensive program of education and research. The Center works to raise public awareness and knowledge, train practicing professionals in effective diagnosis and treatment, develop curricula for graduate level professional education, and foster continued research. To learn more, please visit www.complicatedgrief.columbia.edu