The DOI matches its Crossref record; 22 of the 23 references it cites were found in a registry or an index.
Grief and Depression After Miscarriage: Their Separation, Antecedents, and Course
Abstract
Bereavement is a major risk factor for physical illness, grief, depression, and anxiety. In contrast to recent tendencies in the psychiatric literature to equate grief and depression, we propose that a careful discrimination between the two must be made for diagnostic, therapeutic, and investigative purposes. We report the results of a longitudinal study of a frequent but neglected event, miscarriage early in pregnancy, to make this point. Clinical criteria for differentiating grief and depressive reactions were developed based on phenomenological criteria and theoretical considerations. We hypothesized that the detrimental psychological and physical consequences occur only when the miscarriage was not mourned and resulted in a depressive reaction, but not in a grief reaction. In a controlled, representative study, 125 consecutive women were assessed shortly after their miscarriage (before the 20th week of gestation) and 6 months (N = 94) and 12 months (N = 90) later. Assessments included standardized questionnaires for life events, depression, physical complaints, anxiety, and a specific, multidimensional grief scale (Munich Grief Scale) that we had developed previously. Immediately after the miscarriage, the average anxiety and depression scores were elevated when compared with 80 pregnant and 125 age-matched community controls. Twenty percent of the patients who had miscarried showed a grief reaction, 12% showed a depressive reaction, and 20% responded with a combined depressive and grief reaction. The remaining women (48%) reported no changes in their emotional reactions. As predicted, longer-lasting psychological, social, and health status changes followed the initial depressive, but not the grief reactions. Depressive reactions were predicted by a history of previous depression, a lack of social resources, and an ambivalent attitude to the lost fetus. The grief measures were reliable and made it possible to discriminate between grief and depression.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“As mentioned above, ambivalent attitudes toward the pregnancy were found to be associated with more intense grief reactions, and loss of an unplanned pregnancy was often reacted to in the same way.37,38”
From Complicated grief after perinatal loss (2012) · cites this paper as [38]
In the citing paper
“A number of further predictors have been generally associated with psychological morbidity after prenatal loss, but no specific relationships could be found between grief and maternal age, marital status, or occupational status.22,37,38”
From Complicated grief after perinatal loss (2012) · cites this paper as [38]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Freud, S. (1922) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-192211000-00066 · Cited by 5,444
STAI manual for the State-trait anxiety inventory
Cd, S. (1970) · Medical Entomology and Zoology · Cited by 2,433
The myths of coping with loss.
Wortman, C. B., & Silver, R. C. (1989) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.57.3.349 · Cited by 938
Bereavement: Reactions, Consequences, and Care.
Owen, G., Osterweis, M., Solomon, F., & Green, M. (1985) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2071413 · Cited by 497
Engel, G. L. (1961) · Psychosomatic Medicine · doi:10.1097/00006842-196101000-00002 · Cited by 354
Depression through the first year after the death of a spouse
Zisook, S., & Shuchter, S. R. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.10.1346 · Cited by 307
A Life Setting Conducive to Illness
Engel, G. L. (1968) · Annals of Internal Medicine · doi:10.7326/0003-4819-69-2-293 · Cited by 302
The Perinatal Grief Scale: Development and initial validation.
Toedter, L. J., Lasker, J. N., & Alhadeff, J. M. (1988) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.1988.tb01604.x · Cited by 297
Perturbing the organism: the biology of stressful experience
(1993) · Choice Reviews Online · doi:10.5860/choice.30-2669 · Cited by 285
Research works printed but not linked: 6
- Engel, 1968, Arch Intern Med, 69, 293
- Beutel, 1992, Psychother Psychosommed Psychol, 42, 158
- Beutel, 1993, Psychother Psychosommed Psychol, 43, 411
- Smith, 1988, Contemp Rev Obstet Gynaecol, 1, 43
- Beutel, 1995, Psychother Psychosommed Psychol, 45, 295
- Beutel, 1993, Forum Psychoanal, 9, 223
Cited by
Sorted by citations
Complicated grief after perinatal loss
Kersting, A., & Wagner, B. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/akersting · Cited by 419
“loss, but no specific relationships could be found between grief and maternal age, marital status, or occupational status.(22,37,38)”
BackgroundPsychological morbidity following miscarriage
Lok, I. H., & Neugebauer, R. (2007) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2006.11.007 · Cited by 302
Grief Following Miscarriage: A Comprehensive Review of the Literature
Brier, N. (2008) · Journal of Women's Health · doi:10.1089/jwh.2007.0505 · Cited by 287
“Beutel et al., 3 on the other hand, administered standardized independent measures of grief and depression to women who experienced a spontaneous abortion.”
Previous prenatal loss as a predictor of perinatal depression and anxiety
Blackmore, E. R., Côté-Arsenault, D., Tang, W., Glover, V., Evans, J., Golding, J., & O'Connor, T. G. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.bp.110.083105 · Cited by 315
“5,9,6,27 The current study extends this work by showing that the impact persists well past the subsequent pregnancy and despite the birth of a healthy child (indexed here by birth weight and gestational age of the subsequent child).”
The psychological impact of early pregnancy loss
Farren, J., Mitchell-Jones, N., Verbakel, J. Y., Timmerman, D., Jalmbrant, M., & Bourne, T. (2018) · Human Reproduction Update · doi:10.1093/humupd/dmy025 · Cited by 268
Metadata
- Authors
- Beutel, M., Deckardt, R., von Rad, M., & Weiner, H.
- Affiliations
- University of California, Los Angeles (US)
- ORCID
- Beutel, Manfred
- Venue
- Psychosomatic Medicine
- Published
- 1995
- Volume
- 57
- Issue
- 6
- Pages
- 517-526
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2010032202
- Cited by
- 140
- References
- 23
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 8 · 2014: 10 · 2013: 7 · 2012: 7
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- miscarriage, grief, depression, bereavement, differential diagnosis, anxiety, physical complaints, social support, longitudinal follow-up
- MeSH terms
- Abortion, Spontaneous, Adaptation, Psychological, Adolescent, Adult, Anxiety Disorders, Bereavement, Depressive Disorder, Diagnosis, Differential, Female, Gestational Age, Grief, Humans, Life Change Events, Middle Aged, Pregnancy, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Risk Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review