abnormal grief; depressive grief; complicated grief; prolonged grief disorder

Classification

2 patterns:

• depressive pattern
  • excessive rumination about acts of commission
  • extreme vegetative symptoms
  • profoundly & persistently depressed mood
  • complete anhedonia
  • major sleep disturbance
  • feelings of worthless or hopelessness
  • active thought of suicide
  • depressed symptoms extending more than 2 months from loss
• complicated grief
  • abnormal functioning
  • persistent & prolonged yearning for the deceased
  • crying, searching, disbelieving in the loss
  • established 6 months after loss

Etiology

• excessive dependence on the deceased
• latent psychosis
• traumatic loss
  • unexpected loss
  • multiple losses
  • homicide
  • suicide
  • loss of a child

Management

• treatment of depression
• psychotherapy
  • complicated grief therapy emphasizing exposure to painful grief memories better than interpersonal therapy
  • psychotherapy dimimishes all symptoms of complicated grief (NNT=3.6); citalopram treats only depression
• support groups for traumatic losses
• AVOID confronting denial; it may serve as a defense against a psychosis

More general terms

• grief

Additional terms

• bereavement