DIAGNOSTIC-CRITERIA FOR COMPLICATED GRIEF DISORDER

Objective: Some prolonged and turbulent grief reactions include sympto ms that differ from the DSM-IV criteria for major depressive disorder. The authors investigated a new diagnosis that would include these sym ptoms. Method: They developed observer-based definitions of 30 symptom s noted clinically in previous longitudinal interviews of bereaved per sons and then designed a plan to investigate whether any combination o f these would serve as criteria for a possible new diagnosis of compli cated grief disorder. Using a structured diagnostic interview, they as sessed 70 subjects whose spouses had died. Latent class model analyses and signal detection procedures were used to calibrate the data again st global clinical ratings and self-report measures of grief-specific distress. Results: Complicated grief disorder was found to be characte rized by a smaller set of the assessed symptoms. Subjects selected by an algorithm for these symptom patterns did not significantly overlap with subjects who received a diagnosis of major depressive disorder. C onclusions: A new diagnosis of complicated grief disorder may be indic ated. Its criteria would include the current experience (more than a y ear after a loss) of intense intrusive thoughts, pangs of severe emoti on, distressing yearnings, feeling excessively alone and empty, excess ively avoiding tasks reminiscent of the deceased, unusual sleep distur bances, and maladaptive levels of loss of interest in personal activit ies.