Uncomplicated Depression, Suicide Attempt, and the DSM-5 Bereavement Exclusion Debate: An Empirical Evaluation

Jerome C. Wakefield, Mark F. Schmitz

    Research output: Contribution to journalArticle

    Abstract

    Purpose: To evaluate the claim, made repeatedly during Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition debatesover eliminating the bereavement exclusion (BE), that "uncomplicated" depressive reactions have elevated suicidality like othermajor depressive disorder (MDD), so exclusions risk missing suicidal cases. Method: We found no published evidence assessingsuicide risk specifically in uncomplicated depression. Using data from four epidemiological surveys, we calculated suicide attemptrates both concurrently and predictively for those with histories of no MDD, uncomplicated MDD, and standard MDD. Results: Both concurrently and predictively, uncomplicated MDD suicide attempt rates were no greater than no-MDD history rates andless than standard MDD rates. Discussion: Excluding uncomplicated cases from MDD poses no risk of missing elevated suicidalrates typical of depression. The "suicide" argument used to support BE elimination was spurious.

    Original languageEnglish (US)
    Pages (from-to)37-49
    Number of pages13
    JournalResearch on Social Work Practice
    Volume24
    Issue number1
    DOIs
    StatePublished - Jan 1 2014

    Fingerprint

    Bereavement
    suicide attempt
    Suicide
    exclusion
    Depression
    suicide
    evaluation
    Depressive Disorder
    mental disorder
    history
    Diagnostic and Statistical Manual of Mental Disorders
    diagnostic
    History
    evidence

    Keywords

    • bereavement exclusion
    • depression
    • DSM-5
    • grief
    • suicide attempt

    ASJC Scopus subject areas

    • Social Sciences (miscellaneous)
    • Sociology and Political Science
    • Psychology(all)

    Cite this

    Uncomplicated Depression, Suicide Attempt, and the DSM-5 Bereavement Exclusion Debate : An Empirical Evaluation. / Wakefield, Jerome C.; Schmitz, Mark F.

    In: Research on Social Work Practice, Vol. 24, No. 1, 01.01.2014, p. 37-49.

    Research output: Contribution to journalArticle

    @article{45d998ba9204473cb5151d9d5bbd7461,
    title = "Uncomplicated Depression, Suicide Attempt, and the DSM-5 Bereavement Exclusion Debate: An Empirical Evaluation",
    abstract = "Purpose: To evaluate the claim, made repeatedly during Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition debatesover eliminating the bereavement exclusion (BE), that {"}uncomplicated{"} depressive reactions have elevated suicidality like othermajor depressive disorder (MDD), so exclusions risk missing suicidal cases. Method: We found no published evidence assessingsuicide risk specifically in uncomplicated depression. Using data from four epidemiological surveys, we calculated suicide attemptrates both concurrently and predictively for those with histories of no MDD, uncomplicated MDD, and standard MDD. Results: Both concurrently and predictively, uncomplicated MDD suicide attempt rates were no greater than no-MDD history rates andless than standard MDD rates. Discussion: Excluding uncomplicated cases from MDD poses no risk of missing elevated suicidalrates typical of depression. The {"}suicide{"} argument used to support BE elimination was spurious.",
    keywords = "bereavement exclusion, depression, DSM-5, grief, suicide attempt",
    author = "Wakefield, {Jerome C.} and Schmitz, {Mark F.}",
    year = "2014",
    month = "1",
    day = "1",
    doi = "10.1177/1049731513495092",
    language = "English (US)",
    volume = "24",
    pages = "37--49",
    journal = "Research on Social Work Practice",
    issn = "1049-7315",
    publisher = "SAGE Publications Inc.",
    number = "1",

    }

    TY - JOUR

    T1 - Uncomplicated Depression, Suicide Attempt, and the DSM-5 Bereavement Exclusion Debate

    T2 - An Empirical Evaluation

    AU - Wakefield, Jerome C.

    AU - Schmitz, Mark F.

    PY - 2014/1/1

    Y1 - 2014/1/1

    N2 - Purpose: To evaluate the claim, made repeatedly during Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition debatesover eliminating the bereavement exclusion (BE), that "uncomplicated" depressive reactions have elevated suicidality like othermajor depressive disorder (MDD), so exclusions risk missing suicidal cases. Method: We found no published evidence assessingsuicide risk specifically in uncomplicated depression. Using data from four epidemiological surveys, we calculated suicide attemptrates both concurrently and predictively for those with histories of no MDD, uncomplicated MDD, and standard MDD. Results: Both concurrently and predictively, uncomplicated MDD suicide attempt rates were no greater than no-MDD history rates andless than standard MDD rates. Discussion: Excluding uncomplicated cases from MDD poses no risk of missing elevated suicidalrates typical of depression. The "suicide" argument used to support BE elimination was spurious.

    AB - Purpose: To evaluate the claim, made repeatedly during Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition debatesover eliminating the bereavement exclusion (BE), that "uncomplicated" depressive reactions have elevated suicidality like othermajor depressive disorder (MDD), so exclusions risk missing suicidal cases. Method: We found no published evidence assessingsuicide risk specifically in uncomplicated depression. Using data from four epidemiological surveys, we calculated suicide attemptrates both concurrently and predictively for those with histories of no MDD, uncomplicated MDD, and standard MDD. Results: Both concurrently and predictively, uncomplicated MDD suicide attempt rates were no greater than no-MDD history rates andless than standard MDD rates. Discussion: Excluding uncomplicated cases from MDD poses no risk of missing elevated suicidalrates typical of depression. The "suicide" argument used to support BE elimination was spurious.

    KW - bereavement exclusion

    KW - depression

    KW - DSM-5

    KW - grief

    KW - suicide attempt

    UR - http://www.scopus.com/inward/record.url?scp=84890190391&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84890190391&partnerID=8YFLogxK

    U2 - 10.1177/1049731513495092

    DO - 10.1177/1049731513495092

    M3 - Article

    AN - SCOPUS:84890190391

    VL - 24

    SP - 37

    EP - 49

    JO - Research on Social Work Practice

    JF - Research on Social Work Practice

    SN - 1049-7315

    IS - 1

    ER -