Cited by 398Grief, Bereavement, and Mental HealthMental Health Treatment and AccessPosttraumatic Stress Disorder Research

The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index.

The Burden of Loss: Unexpected Death of a Loved One and Psychiatric Disorders Across the Life Course in a National Study

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Abstract

OBJECTIVE: Unexpected death of a loved one is common and associated with subsequent elevations in symptoms of multiple forms of psychopathology. Determining whether this experience predicts novel onset of psychiatric disorders and whether these associations vary across the life course has important clinical implications. The authors examined associations of a loved one's unexpected death with first onset of common anxiety, mood, and substance use disorders in a population-based sample. METHOD: The relation between unexpected death of a loved one and first onset of lifetime DSM-IV disorders was estimated by using a structured interview of adults in the U.S. general population (analytic sample size=27,534). Models controlled for prior occurrence of any disorder, other traumatic experiences, and demographic variables. RESULTS: Unexpected death of a loved one was the most common traumatic experience and most likely to be rated as the respondent's worst, regardless of other traumatic experiences. Increased incidence after unexpected death was observed at nearly every point across the life course for major depressive episode, panic disorder, and posttraumatic stress disorder. Increased incidence was clustered in later adult age groups for manic episode, phobias, alcohol use disorders, and generalized anxiety disorder. CONCLUSIONS: The bereavement period is associated with elevated risk for the onset of multiple psychiatric disorders, consistently across the life course and coincident with the experience of the loved one's death. Novel associations between unexpected death and onset of several disorders, including mania, confirm multiple case reports and results of small studies and suggest an important emerging area for clinical research and practice.

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Crossref · 10.1176/appi.ajp.2014.13081132

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Research works printed but not linked: 6

  1. 10.3109/10401239809147032 · DOI
  2. Kaplow JB, 2010, J Am Acad Child Adolesc Psychiatry, 49, 1145
  3. Krishnan KRR, 1984, J Clin Psychiatry, 45, 310
  4. Berlin RM, 1985, J Clin Psychiatry, 46, 111
  5. Bourgeois M, 1987, Ann Med Psychol (Paris), 145, 72
  6. Meynert TH, 1890, Klinische Vorlesungen über Psychiatrie

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Metadata

Authors
Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K.
Affiliations
Boston Children's Hospital (US)
Venue
American Journal of Psychiatry
Published
2014-08
Volume
171
Issue
8
Pages
864-871
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
OpenAlex
W2111636212
Cited by
398
References
49
Citations by year
2026: 28 · 2025: 33 · 2024: 47 · 2023: 55 · 2022: 45 · 2021: 50 · 2020: 41 · 2019: 30 · 2018: 25 · 2017: 15 · 2016: 14 · 2015: 10 · 2014: 5
FWCI
17.31
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r01mh093612-03, MH093612)
  • National Institute on Alcohol Abuse and Alcoholism (AA-021511, K01AA021511)
  • National Institute of Mental Health (MH093612, MH-092526, R01MH070741, R01MH078928, MH60783, R01-MH093612, MH-078928, MH70741, R01MH060783, K01MH092526)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
bereavement, life course, major depressive episode, manic episodes, panic disorder, post-traumatic stress disorder, phobia, generalized anxiety disorder, alcoholism, substance use disorders, traumatic events, DSM-IV disorders
MeSH terms
Age Factors, Mental Disorders, Bereavement, Death, Humans, United States, Incidence, Cost of Illness

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