Is bereavement-related depression different than non-bereavement-related depression?

Zisook, Sidney; Kendler, Kenneth S.

doi:10.1017/s0033291707009865

Cited by 123 publications

(98 citation statements)

References 102 publications

(159 reference statements)

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“…Other SLE associated with major depression do not lead to exclusion from the diagnosis of MDD or any other axis I diagnosis. In their literature review, Zisook and Kendler [8] concluded that bereavement-related depression has more similarities than differences with MDD. Several authors [5][6][7][8][47][48][49] have questioned the validity of excluding bereavement from major depression when all other criteria are met.…”

Section: Dsm Axis I and Sle Including Bereavementmentioning

confidence: 99%

“…Bereavement is the only stressful life event (SLE) which is an exclusion criterion for a DSM axis I diagnosis, unless depressive symptoms associated with bereavement last longer than 2 months or meet the bereavement descriptive E criterion for major depression. Several authors have questioned the validity of excluding bereavement from major depression when all other inclusion criteria are met [5][6][7][8] . SLE, including bereavement, have been found to contribute to, initiate and maintain MDD [9][10][11][12][13][14][15][16][17] .…”

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confidence: 99%

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Beyond DSM-IV Bereavement Exclusion Criterion E for Major Depressive Disorder

Chouinard

2011

Psychother Psychosom

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ticle, we propose to revise DSM-IV bereavement exclusion and keep the V code for bereavement as suggested by Paula Clayton [19] . In addition, in the event that criterion E is deleted, we believe that criterion A for major depression should be revised to require at least 7 of the 9 criterion A inclusion symptoms for MDE in all types of MDD, which would satisfy the concerns raised by Lichtenberg and Belmaker [3] and Bech [4] about the overinclusiveness of criterion A, leading to overdiagnosis of MDE. Adjusting the number of inclusion symptoms of criterion A reinforces the dimensional approach to depression initiated by the DSM-III (1980) and DSM-III-R (1987). To avoid a 'single catchall entity' diagnosis of MDE [3] , depression subtypes can be used, including bereavement depression. Now is the time to reevaluate depression subtypes and MDD, and allow subtypes for some of the welldefined stress event depressions. Bereavement and Major DepressionBereavement is known to be associated with high rates of MDE and of other major depressive syndromes [20][21][22][23][24][25][26][27][28][29] . Major depression is common during the first year of bereavement, with higher rates earlier in bereaveThere are two issues facing the DSM-V in the revision of the criteria for major depressive disorder (MDD), the first being the concept of DSM-III [1] criterion A inclusion symptoms for major depressive episode (MDE), which has recently been addressed by Fava et al. [2] , Lichtenberg and Belmaker [3] and Bech [4] . The second concerns bereavement criterion E, which often leads to exclusion from MDE. The rationale behind criterion E was that symptoms of bereavement-related sadness resemble those of major depression without the presence of MDD. Bereavement is the only stressful life event (SLE) which is an exclusion criterion for a DSM axis I diagnosis, unless depressive symptoms associated with bereavement last longer than 2 months or meet the bereavement descriptive E criterion for major depression. Several authors have questioned the validity of excluding bereavement from major depression when all other inclusion criteria are met [5][6][7][8] . SLE, including bereavement, have been found to contribute to, initiate and maintain MDD [9][10][11][12][13][14][15][16][17] . More recently, we reported that DSM-IV bereavement-excluded subjects were more severely depressed than MDE subjects without bereavement, and at least as severely depressed as MDE subjects with bereavement [18] . At this time, the DSM-V is proposing to delete bereavement exclusion criterion E for major depression (www.DSM5.org). In the present ar-

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Section: Dsm Axis I and Sle Including Bereavementmentioning

confidence: 99%

mentioning

confidence: 99%

Beyond DSM-IV Bereavement Exclusion Criterion E for Major Depressive Disorder

Chouinard

2011

Psychother Psychosom

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“…Depressive symptoms are an expected reaction to loss, but pervasive symptoms lasting more than two months may signify a depressive disorder. Some have proposed that depression associated with bereavement is a distinct syndrome called complicated grief, characterized by symptoms of separation distress and traumatic distress (Prigerson et al, 1995).Others have argued, however, that the similarities between complicated grief and standard major depression outweigh the differences (Zisook & Kendler, 2007).…”

Section: Stressful Life Events-mentioning

confidence: 99%

Depression in Older Adults

Zauszniewski¹,

Bekhet²,

Wykle³

2002

Depression: A Primer for Practitioners

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Depression is less prevalent among older adults than among younger adults but can have serious consequences. Over half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. Risk factors leading to the development of late life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support.

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“…essentially identical to other, non-bereavement-related depressions, and 2 recent literature reviews 8,9 have found that the preponderance of available data provide little support for the bereavement exclusion. Bereavement-related depressions are similar to other, non-bereavement-related depressions in risk factors, intensity, course, comorbidity, biologic features, and treatment response.…”

mentioning

confidence: 92%