Complicated Grief

2012 ◽  
pp. 9-31
Author(s):  
Roslyn Law
Keyword(s):  
Suicidal Ideation ◽  
Major Depression ◽  
Functional Impairment ◽  
Complicated Grief ◽  
Psychomotor Retardation ◽  
Psychotic Symptoms ◽  
Significant Other ◽  
Dsm Iv

Chapter 2 discusses complicated grief, and how the IPT therapist selects grief as an interpersonal focus when the onset of the patient’s symptoms is associated with the death of a significant other and manifests in a bereavement-related depression. It covers how this reaction differs from the predictable sorrow associated with bereavement – the experience of deprivation and desolation. It examines how the DSM-IV echoes this distinction by excluding immediate bereavement reactions in making the diagnosis of major depression, and how clinicians may diagnose major depression only if symptoms persist for more than 2 months after the death or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

scholarly journals Symptom Profile and Severity in a Sample of Nigerians with Psychotic versus Nonpsychotic Major Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Increase Ibukun Adeosun ◽  
Oyetayo Jeje
Keyword(s):  
Suicidal Ideation ◽  
Major Depression ◽  
Rating Scale ◽  
Somatic Symptoms ◽  
Psychomotor Retardation ◽  
Sub Saharan Africa ◽  
Psychotic Symptoms ◽  
Symptom Profile ◽  
Psychotic Major Depression ◽  
Sub Saharan

The therapeutic strategies in managing patients with psychotic major depression (PMD) differ from those with non-psychotic major depression (NMD), because of differences in clinical profile and outcome. However, there is underrecognition of psychotic symptoms in depressed patients. Previous studies in Western population suggest that certain symptom patterns, apart from psychosis which may be concealed, can facilitate the discrimination of PMD from NMD. These studies may have limited applicability to sub-Saharan Africa due to cross-cultural differences in the phenomenology of depression. This study compared the rates and severity of depressive symptoms in outpatients with PMD (n=129) and NMD (n=117) using the Structured Clinical Interview for Depression (SCID) and Hamilton Depression Rating Scale (HAM-D). Patients with PMD had statistically significantly higher rates of suicidal ideation, suicidal attempt, psychomotor agitation, insomnia, and reduced appetite. Patients with NMD were more likely to manifest psychomotor retardation and somatic symptoms. PMD was associated with greater symptom severity. On logistic regression analysis, suicidal ideation, psychomotor disturbances, insomnia, and somatic symptoms were predictive of diagnostic status. The presence of these symptoms clusters may increase the suspicion of occult psychosis in patients with depression, thereby informing appropriate intervention strategies.

How accurate is recall of key symptoms of depression? A comparison of recall and longitudinal reports

2004 ◽  
Vol 34 (6) ◽  
pp. 1001-1011 ◽  
Author(s):  
J. ELISABETH WELLS ◽  
L. JOHN HORWOOD
Keyword(s):  
Risk Factors ◽  
Sexual Abuse ◽  
Suicidal Ideation ◽  
Major Depression ◽  
Parental Attachment ◽  
Study Cohort ◽  
Symptoms Of Depression ◽  
Health And Development ◽  
Dsm Iv ◽  
Symptom Measures

Background. Assessment of lifetime major depression is usually made from a single interview. Most previous studies have investigated reliability. Comparison of recall of key symptoms and longitudinal reports shows the accuracy of recall, not just reliability.Method. At age 25, 1003 members of the Christchurch Health and Development Study cohort were asked to recall key symptoms of depression (sadness, loss of interest) up to age 21. This recall was compared with longitudinal reports at ages 15, 16, 18 and 21 years. Diagnosis was by DSM-III-R and DSM-IV criteria.Results. Only 4% of those without previous reports recalled key symptoms. Of those with a diagnosis of depression up to age 21, 44% recalled a key symptom. Measures of severity of an episode (number of symptoms, impairment, duration, suicidality) and chronicity (years with a diagnosis, years with suicidal ideation) all strongly predicted recall. Current key symptoms increased recall, even after taking account of severity and chronicity. Being female and receiving treatment also predicted recall, although odds ratios were reduced to 1·6–1·7 when all other predictors were included. Comparison of risk factors for key symptoms showed similar results from longitudinal reports and recall. Sexual abuse, neuroticism, lack of parental attachment, gender, physical abuse and maternal depression were major risk factors in both sets of analyses.Conclusions. Forgetting of prior episodes of depression was common. Severity, chronicity, current depression, gender and treatment predicted recall. Lifetime prevalence based on recall will be markedly underestimated but the identification of major risk factors may be relatively little impaired.

scholarly journals Picking Up the Pieces: Coping with a Friend's Suicide

2020 ◽  
Vol 3 (2) ◽  
pp. 139-140
Author(s):  
Gemma L. Labestre, MST ◽  
Lisa Anna M. Gayoles
Keyword(s):  
Major Depression ◽  
Lived Experiences ◽  
Complicated Grief ◽  
Well Being ◽  
Significant Other ◽  
Depression And Anxiety ◽  
Emotional Trauma ◽  
Dead Person ◽  
Left Behind ◽  
Peer Suicide

People left behind have to grieve and accept the powerlessness over death. They have to grapple and face the void left by the dead person. One of the most tragic deaths is suicide. The ultimate sufferers in this tragedy are those left behind to cope with the emotional trauma of losing a significant other, struggling with many unanswerable questions, self-blaming, and an inability to move on with their lives. For adolescents, losing a peer, classmate, or friend to suicide increases their risk of depression and anxiety. Their psychological well-being is compromised, often leading to complicated grief, major depression, and posttrauma stress. The present study aims to explore, describe, and interpret the lived experiences of peer suicide loss survivors.

scholarly journals The structure of the symptoms of major depression: exploratory and confirmatory factor analysis in depressed Han Chinese women

2013 ◽  
Vol 44 (7) ◽  
pp. 1391-1401 ◽  
Author(s):  
Y. Li ◽  
S. Aggen ◽  
S. Shi ◽  
J. Gao ◽  
Y. Li ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Major Depression ◽  
Chinese Women ◽  
Han Chinese ◽  
Psychiatric Interview ◽  
Symptom Dimensions ◽  
Psychiatric Syndrome ◽  
Dsm Iv

BackgroundThe symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?MethodSymptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.ResultsThe preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.ConclusionsMD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.

Functional impairment and previous suicide attempts in bipolar disorder

2008 ◽  
Vol 20 (6) ◽  
pp. 300-306 ◽  
Author(s):  
Adriane R. Rosa ◽  
Carolina Franco ◽  
Anabel Martínez-Aran ◽  
Jose Sánchez-Moreno ◽  
Manel Salamero ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Functional Impairment ◽  
Degrees Of Freedom ◽  
Suicide Attempts ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
History Of ◽  
Dsm Iv ◽  
Bipolar Patients

Objective:The aim of the present study was to assess the association between previous suicide attempts and functional impairment among euthymic patients with bipolar disorder (BD).Methods:Seventy-one Diagnostic Statistical Manual IV (DSM-IV) patients with BD and 61 healthy volunteers were recruited from the Bipolar Disorder Program at the Clinic Hospital of Barcelona. Patients with (n = 36, 50.7%) and without (n = 35, 49.3%) previous suicide attempts were assessed using the Structured Clinical Interview for DSM-IV-TR (SCID-P). Previous suicide attempts were carefully investigated by means of patient and caregiver interview and by a standard structured interview from the protocol of our BD Program. The Functioning Assessment Short Test (FAST) was employed to assess functional impairment.Results:Euthymic patients with previous suicide attempts showed functional impairment, particularly in occupational (F = 30.39; p = 0.001) and cognitive functioning (F = 18.43; p = 0.001). In addition, family history of psychiatric illness (χ2: 6.49; degrees of freedom (df) = 2;132; p = 0.010), family history of affective disorders (χ2 = 5.57; p = 0.017), psychotic symptoms (χ2 = 5.88; p = 0.014) and axis II comorbidity were associated with previous suicide attempts (χ2 = 5.16; p = 0.021).Conclusion:Bipolar patients with previous suicide attempts had lower overall functioning than patients who did not attempt suicide. Previous suicide attempts were particularly associated with the occupational and cognitive domains of functioning.

MCP-2/CCL8 Level Associated With Suicidal Ideation in Elderly Men With Major Depression

2020 ◽  
Vol 24 (3) ◽  
pp. 467-476
Author(s):  
Mu-N Liu ◽  
Shih-Jen Tsai ◽  
Heng-Liang Yeh ◽  
Chih-Ching Wu ◽  
Ching-Po Lin
Keyword(s):  
Suicidal Ideation ◽  
Major Depression ◽  
Elderly Men

Evaluation of Functionality in Families with Depressed Patient by Using the FFS - Poster Prezentation

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
T. Maria-Silvia
Keyword(s):  
Major Depression ◽  
Depressive Disorder ◽  
Positive Affect ◽  
Psychiatric Patients ◽  
Normal Families ◽  
Control Group ◽  
World Population ◽  
Dsm Iv ◽  
The Individual ◽  
Family Functionality

Depression is a disorder of representation and regulation of mood and emotion; it affects 5% of world population, in a year. Unlike normal loss and sadness feelings, major depression is persistant and it interferes significantly with thoughts, behaviour, emotions, activity and health of the individual. If untreated, depression can lead to suicide. Using family therapy in treating psychiatric patients is a must due to the significance that a family holds in individual and society life.Objective:Assesing family functionality in families with a member diagnosed according to DSM IV TR with depressive disorder; depression intensity was assesed with HDRS.Methods:A sample of 3o families (71 members); FFS assesses the most important and consistent five functioning areas: positive affect, comunication, conflicts, worries and rituals.Results:Values obtained in each of the 40 questions of the scale can give information on variables affecting the increase or decrease in subscales values. Positive affect 35,07, communication 37, conflicts 15,11, worries 40,77, rituals 45,03. The reuslts were compared to those obtained by assessin normal families from a control group of 132 families (323 members).Conclusions:Differences were noticed. Values obtained in our study represent the standard of functioning of families with a depressed member.

DSM-IV “major depression”: Are more stringent criteria needed?

Depression ◽  
1993 ◽  
Vol 1 (1) ◽  
pp. 24-28 ◽  
Author(s):  
James H. Kocsis
Keyword(s):  
Major Depression ◽  
Dsm Iv
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