Clinical and Biological Aspects of Bereavement and Loss-Induced Depression: A Reappraisal
Abstract
Loss and bereavement can be regarded as risk factors for the development of psychiatric and medical illness. Vulnerability to physical illness and mortality are increased during the first 2 years of bereavement, with men at higher risk than women. Symptoms of anxiety and a frank depressive syndrome are common during the first months of bereavement and, although depressive symptoms are usually transient and self-limited, bereaved individuals not rarely go on to develop major depression. In our perspective, loss perceived as irreparable, and persistence of perceived loss may favour the development of complicated grief and depression. Factors such as unexpectedness, absence of social support, concurrent loss or illness, and grief proneness may predict poor adjustment after bereavement. Complicated bereavement should be distinguished from uncomplicated bereavement, because patients with the latter need no treatment. In humans, there is evidence of increased adrenocortical activity and altered immune function following bereavement, whereas in non-human primates, biogenic amine systems appear to be involved in the response to maternal or social separation. According to a ‘psychosomatic view of the brain’, critical life events can both affect brain neurotransmitters and contribute to psychological and somatic symptoms of depression. Emotional events may be transduced into long-lasting brain changes, involving neurotransmitters, neuropeptides and receptors. Although only very limited evidence exists, long-term consequences could involve changes at the gene expression level.
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Loss of a partner is associated with increased depression.
“loss of a partner can be one of the most devastating experiences of a person’s lifetime and is associated with increased depression (Biondi and Picardi 1996; Watanabe et al. 2004; Zisook et al. 1994, 1997; Assareh et al. 2015).”
From Oxytocin and Social Relationships: From Attachment to Bond Disruption (2017) · cites this paper as Biondi and Picardi 1996
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“have also reported that plasma levels of cortisol and prolactin increase during unemployment.As for bereavement, it represents a major risk factor for the development of both psychiatric and medical morbidity. Moreover, in bereaved individuals there is evidence of increased adrenocortical activity and altered immune f…”
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“A number of health studies in humans have also shown that social support reduces the frequency of depression (Biondi and Picardi, 1996; Coyne and Downey, 1991; Elmore, 1984, Miller and Surtees, 1995, Paykel, 1994) and the incidence of disease-related mortality and morbidity (Cohen, 1988).”
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Psychological stress and neutrophil function
Khanfer, R. (2011) · University of Birmingham Institutional Research Archive (University of Birmingham)
- Authors
- Biondi, M., & Picardi, A.
- Affiliations
- Sapienza University of Rome (IT)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2010-02-18
- Volume
- 65
- Issue
- 5
- Pages
- 229-245
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W1994932307
- Cited by
- 91
- References
- 0
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 2 · 2018: 1 · 2017: 3 · 2016: 1 · 2015: 1 · 2014: 4 · 2013: 3 · 2012: 3
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Keywords
- bereavement, complicated grief, major depressive disorder, anxiety, social support, adrenocortical function, immune function, maternal separation, social separation, neurotransmitters, neuropeptides, gene expression, sex differences, mortality risk
- MeSH terms
- Mental Disorders, Bereavement, Depressive Disorder, Female, Humans, Hydrocortisone, Killer Cells, Natural, Life Change Events, Male, Middle Aged, Psychoneuroimmunology, Stress, Psychological
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