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Cited by 333Grief, Bereavement, and Mental HealthDeath, Funerary Practices, and MourningPosttraumatic Stress Disorder Research

The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief

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Simon, Naomi M., Shear, Katherine M., Thompson, Elizabeth H., Zalta, Alyson K., Perlman, Carol, Reynolds, Charles F., Frank, Ellen, Melhem, Nadine M. +1 more·2007·Comprehensive Psychiatry
DOI 10.1016/j.comppsych.2007.05.002
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Abstract

Background Complicated grief (CG), variously called pathological or traumatic grief, is a debilitating syndrome that is not currently included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV) nomenclature. One issue that remains under debate is whether this condition can be clearly distinguished from other psychiatric disorders, such as major depression and posttraumatic stress disorder, with which CG frequently coexists.Methods Using a structured clinical interview for CG and the Structured Clinical Interview for DSM-IV, trained experienced raters conducted careful diagnostic assessments of individuals seeking treatment of bereavement-related distress. All study participants met criteria for a current CG syndrome. Liberal criteria were used to diagnose DSM-IV disorders, making no attempt to decide if symptoms could be explained by grief.Results Of 206 who met the criteria for CG, 25% had no evidence of a current DSM-IV Axis I disorder. When present, psychiatric comorbidity was associated with significantly greater severity of grief; however, even after adjustment for the presence of comorbidity, severity of CG symptoms was associated with greater work and social impairment.Limitations It is likely that our study underestimated the rate of CG without comorbidity because fewer DSM diagnoses would have been made if a judgment about grief had been taken into consideration.Conclusions Our data provide further support for the need to identify CG as a psychiatric disorder.

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Authors
Simon, N. M., Shear, K. M., Thompson, E. H., Zalta, A. K., Perlman, C., Reynolds, C. F., Frank, E., Melhem, N. M., & Silowash, R.
Affiliations
  • Harvard University (US)
  • Columbia University (US)
  • University of Pittsburgh (US)
Corresponding author
Simon, Naomi M.
ORCID
Venue
Comprehensive Psychiatry
Publisher
Elsevier BV
Published
2007-09
Volume
48
Issue
5
Pages
395-399
ISSN
0010-440X (ISSN-L)
DOI
10.1016/j.comppsych.2007.05.002
OpenAlex
W2039969250
Cited by
333
References
32
Citations by year
2026: 4 · 2025: 9 · 2024: 23 · 2023: 22 · 2022: 22 · 2021: 22 · 2020: 30 · 2019: 24 · 2018: 34 · 2017: 24 · 2016: 9 · 2015: 21 · 2014: 20 · 2013: 18 · 2012: 20
FWCI
6.88
Type
journal article
Language
en
Open access
Licence
Locations
  • Comprehensive Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
National Institute of Mental Health (P30-MH 71944, MH60783, R01MH060783, P30MH071944, MH30915)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
complicated grief, pathological grief, psychiatric comorbidity, major depressive disorder, post-traumatic stress disorder, grief severity
MeSH terms
Adolescent, Adult, Major Depressive Disorder, Female, Grief, Humans, Male, Severity of Illness Index, Social Behavior, Stress Disorders, Post-Traumatic, Observer Variation, Comorbidity, Prevalence, Panic Disorder, Diagnostic and Statistical Manual of Mental Disorders

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