Recurrence of depression after bereavement-related depression: Evidence for the validity of DSM-IV bereavement exclusion from the epidemiologic catchment area study

Jerome C. Wakefield, Mark F. Schmitz

    Research output: Contribution to journalArticle

    Abstract

    The DSM-IV diagnostic criteria for major depressive disorder exclude bereavement-related depressive episodes that are brief and lack certain severe symptoms and are thus better explained as normal grief responses. However, the DSM-5 Task Force proposes to eliminate this exclusion because of a lack of evidence that such episodes differ relevantly from standard major depression. Using the two-wave longitudinal Epidemiologic Catchment Area Study, we compared 1-yr depression recurrence rates at wave 2 of four groups at wave 1 baseline: (1) those with no history of depressive disorder (n = 18,239), (2) those who had only lifetime excludable bereavement-related depression (n = 25), (3) those with brief-episode (≤2 months duration) lifetime standard depressive disorder (n = 446), and (4) those with nonbrief lifetime standard depressive disorder (n = 581). The recurrence rate in the excludable-depression group (3.7%) was not significantly different from the no-history group (1.7%) but was significantly and substantially lower than in the brief and nonbrief standard depression groups (14.4% and 16.2%, respectively). These findings confirm findings reported by Mojtabai (Arch Gen Psychiatry 68:920-928, 2011) using a different data set and time frame and thus substantially strengthen the support for the validity of bereavement exclusion and for its preservation in the DSM-5.

    Original languageEnglish (US)
    Pages (from-to)480-485
    Number of pages6
    JournalJournal of Nervous and Mental Disease
    Volume200
    Issue number6
    DOIs
    StatePublished - Jun 1 2012

    Fingerprint

    Bereavement
    Diagnostic and Statistical Manual of Mental Disorders
    Depression
    Recurrence
    Depressive Disorder
    Grief
    Major Depressive Disorder
    Advisory Committees
    Psychiatry
    History

    Keywords

    • bereavement
    • Depression
    • diagnosis
    • DSM-5
    • grief
    • harmful dysfunction
    • validity

    ASJC Scopus subject areas

    • Psychiatry and Mental health

    Cite this

    Recurrence of depression after bereavement-related depression : Evidence for the validity of DSM-IV bereavement exclusion from the epidemiologic catchment area study. / Wakefield, Jerome C.; Schmitz, Mark F.

    In: Journal of Nervous and Mental Disease, Vol. 200, No. 6, 01.06.2012, p. 480-485.

    Research output: Contribution to journalArticle

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