When is grief a disease?

摘要

The Lancet asks, "When should grief be classified as a mental illness?" (Feb 18, p 589).1 Our reply is, "never". But some recently bereaved individuals are not simply grieving. They are also experiencing a full-blown major depressive episode. How can physicians help in such cases? That is the crux of the "bereavement exclusion" debate surrounding the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Bereavement-related grief does not immunise against a major depressive episode; indeed, bereavement can precipitate such episodes.