Relation between duration and severity in bereavement-related depression

Jerome C. Wakefield, M. F. Schmitz, J. C. Baer

    Research output: Contribution to journalArticle

    Abstract

    Objective: Prolonged duration is commonly used as an indicator that bereavement-related depression (BRD) is pathological. DSM-IV replaced the traditional 1-year pathology cut-point by a 2-month cut-point. Yet, little evidence exists regarding the validity of these cut-points in indicating increased BRD severity. This study evaluated the validity of the 2-month and 1-year cut-points in differentiating less severe from more severe BRDs in a nationally representative U.S. sample. Method: National Comorbidity Survey respondents with BRD's (n=152) lasting 0-8, 9-52 and >52weeks were evaluated for depression severity using six severity indicators. Cut-point validity was established by discontinuities in severity levels between durations below and above the cut-point. Results: Bereavement-related depressions of >52-week duration were significantly higher than 9- to 52-week BRDs on four of six severity indicators and on a cumulative overall severity measure of mean number of severity indicators per person, whereas ≤8-week and 9- to 52-week durational categories differed on one severity indicator and not on overall severity. Additional analyses using durations 0-12, 13-26, 27-52 and >52weeks suggested that alternative <52-week cut-points also lack validity. Conclusion: The traditional 1-year cut-point validly identifies increasing BRD severity; DSM's 2-month cut-point does not. Duration does not indicate increasing BRD severity before 1year. Research using the 2-month cut-point may yield misleading results.

    Original languageEnglish (US)
    Pages (from-to)487-494
    Number of pages8
    JournalActa Psychiatrica Scandinavica
    Volume124
    Issue number6
    DOIs
    StatePublished - Dec 1 2011

    Fingerprint

    Bereavement
    Depression
    Diagnostic and Statistical Manual of Mental Disorders
    Comorbidity
    Pathology
    Research

    Keywords

    • Bereavement
    • Depression
    • Diagnosis
    • Duration
    • Grief

    ASJC Scopus subject areas

    • Psychiatry and Mental health

    Cite this

    Relation between duration and severity in bereavement-related depression. / Wakefield, Jerome C.; Schmitz, M. F.; Baer, J. C.

    In: Acta Psychiatrica Scandinavica, Vol. 124, No. 6, 01.12.2011, p. 487-494.

    Research output: Contribution to journalArticle

    Wakefield, Jerome C. ; Schmitz, M. F. ; Baer, J. C. / Relation between duration and severity in bereavement-related depression. In: Acta Psychiatrica Scandinavica. 2011 ; Vol. 124, No. 6. pp. 487-494.
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