scholarly journals Two Cases of Persistent Complex Bereavement Disorder Diagnosed in the Acute Inpatient Unit

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Olalekan Olaolu ◽  
Terrence Tumenta ◽  
Samuel Adeyemo ◽  
Olusegun Popoola ◽  
Oluwatoyin Oladeji ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Psychiatric Disorders ◽  
Patient Outcomes ◽  
Inpatient Unit ◽  
Dsm 5 ◽  
Separation Distress ◽  
Pathological Grief ◽  
Persistent Complex Bereavement ◽  
Identity Disruption ◽  
Persistent Complex Bereavement Disorder

Pathological grief has been noted to have considerable adverse effects on affected individuals. In the DSM-5, the diagnosis of complicated grief is included under conditions for further study as Persistent Complex Bereavement Disorder (PCBD). PCBD can be easily missed because it is a relatively new and developing diagnosis. It can also be overlooked when it is comorbid with more common psychiatric disorders. We present 2 patients with PCBD diagnosed in the inpatient unit, while the patients were admitted for comorbid disorders. PCBD contributed immensely to both patients’ suffering and decline in functioning. This report highlights the presentation, diagnoses, and management of these patients. We theorize that paying attention to separation distress, reactive distress to loss, and identity disruption in individuals who have been bereaved for over 12 months will enhance treatment specificity and lead to better patient outcomes.

Differential Associations of Coping Strategies With Grief and Depression in Young Adults: The Role of Cause of Death and Relationship to the Deceased

2020 ◽  
Vol 39 (3) ◽  
pp. 172-194
Author(s):  
Cyrille Kossigan Kokou-Kpolou ◽  
Askar Jumageldinov ◽  
Sunyoung Park ◽  
Nicolas Nieuviarts ◽  
Chama Khales ◽  
...  
Keyword(s):  
Young Adults ◽  
Depressive Symptoms ◽  
Coping Strategies ◽  
Clinical Manifestations ◽  
Related Factors ◽  
Counseling Interventions ◽  
Persistent Complex Bereavement ◽  
Identity Disruption ◽  
Persistent Complex Bereavement Disorder ◽  
The Impact

Introduction: The impact of loss by death in young adults has been underinvestigated, although higher rates of traumatic deaths are reported at this developmental stage. This study examined the relative differential consequences of bereavement-related factors for Persistent Complex Bereavement Disorder (PCBD) and depression. In addition, coping strategies predicting the study outcomes were examined as a function of bereavement-related factors. Methods: The study included 580 bereaved young adults with up to 5-year post loss. They were administered a battery of valided tools measuring PCBD symptoms, normal acute grief reactions as measured by the Core Bereavement Items scale, depressive symptoms, coping strategies, and bereavement-related characteristics. Covariance and regression analyses were used. Results: We found that the dimensions of PCBD and depressive symptoms were differentially associated with the bereavement-related factors. More specifically, the death of an immediate family member was associated with higher levels of PCBD-separation distress, whereas the traumatic death of a friend and romantic partner was more associated with PCBD-social and identity disruption. Furthermore, the study revealed differential associations between PCBD severity, depressive symptoms, and coping strategies as functions of bereavement-related factors. Discussion: The study has provided better understanding of clinical manifestations of PCBD as a function of etiologic risk factors. The results clarifying risk and protective factors are especially useful for improving effective bereavement-health counseling interventions among bereaved young adults.

Symptoms of persistent complex bereavement disorder, depression, and PTSD in a conjugally bereaved sample: a network analysis

2018 ◽  
Vol 48 (14) ◽  
pp. 2439-2448 ◽  
Author(s):  
Matteo Malgaroli ◽  
Fiona Maccallum ◽  
George A. Bonanno
Keyword(s):  
Network Analysis ◽  
Graphical Models ◽  
Community Sample ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Dsm 5 ◽  
Persistent Complex Bereavement ◽  
Core Symptoms ◽  
Persistent Complex Bereavement Disorder ◽  
Conjugally Bereaved

AbstractBackgroundComplicated and persistent grief reactions afflict approximately 10% of bereaved individuals and are associated with severe disruptions of functioning. These maladaptive patterns were defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent complex bereavement disorder (PCBD), but its criteria remain debated. The condition has been studied using network analysis, showing potential for an improved understanding of PCBD. However, previous studies were limited to self-report and primarily originated from a single archival dataset. To overcome these limitations, we collected structured clinical interview data from a community sample of newly conjugally bereaved individuals (N= 305).MethodsGaussian graphical models (GGM) were estimated from PCBD symptoms diagnosed at 3, 14, and 25 months after the loss. A directed acyclic graph (DAG) was generated from initial PCBD symptoms, and comorbidity networks with DSM-5 symptoms of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) were analyzed 1 year post-loss.ResultsIn the GGM, symptoms from the social/identity PCBD symptoms cluster (i.e. role confusion, meaninglessness, and loneliness) tended to be central in the network at all assessments. In the DAG, yearning activated a cascade of PCBD symptoms, suggesting how symptoms lead into psychopathological configurations. In the comorbidity networks, PCBD and depressive symptoms formed separate communities, while PTSD symptoms divided in heterogeneous clusters.ConclusionsThe network approach offered insights regarding the core symptoms of PCBD and the role of persistent yearnings. Findings are discussed regarding both clinical and theoretical implications that will serve as a step toward a more integrated understanding of PCBD.

Cultural Context in DSM Diagnosis: An American Indian Case Illustration of Contradictory Trends

2019 ◽  
Vol 57 (4) ◽  
pp. 567-580 ◽  
Author(s):  
Melanie E. Langa ◽  
Joseph P. Gone
Keyword(s):  
American Indian ◽  
Cultural Context ◽  
Illness Experience ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
History Of ◽  
Culturally Diverse Populations ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

Recent revisions of the Diagnostic and Statistical Manual of Mental Disorders ( DSM) increasingly acknowledge the importance of cultural context for the diagnosis of mental illness. However, these same revisions include evolving diagnostic criteria that simultaneously decontextualize particular disorders such as Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD). As a result, the DSM reflects a contradictory role for context in psychiatric diagnosis. The case analysis presented here frames the consequences of this contradictory trend for an American Indian woman with a history of DSM-IV MDD and PTSD, whose diagnostic portrait is substantively altered in light of more recent DSM-5 criteria. Specifically, consideration of this respondent’s bereavement-related illness experience suggests that a sociocentric cultural frame of reference, which places high value on interdependent personal relationships, is not well-captured by DSM-5’s revised MDD or PTSD criteria, or the newly proposed categories of traumatic bereavement or Persistent Complex Bereavement Disorder. The respondent’s illness experience argues for greater recognition of this contradictory diagnostic trend, suggesting a need for future resolution of this tension toward more valid diagnosis for culturally diverse populations.

Prospective evaluation of the DSM-5 persistent complex bereavement disorder criteria in adults: dimensional and diagnostic approaches

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Elie G. Aoun ◽  
Giovanna Porta ◽  
Nadine M. Melhem ◽  
David A. Brent
Keyword(s):  
Functional Impairment ◽  
High Sensitivity ◽  
Close Relative ◽  
Related Disorder ◽  
Prolonged Grief ◽  
Dsm 5 ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder ◽  
Grief Reactions ◽  
Over Time

Abstract Background We examine the performance of the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) persistent complex bereavement-related disorder (PCBD) criteria in bereaved adults to identify prolonged grief cases determined prospectively. Methods Bereaved adults (n = 138) were assessed at 8, 21, 32, 67, and 90 months after the sudden death of a spouse or close relative. We used latent class growth analysis to identify the longitudinal trajectories of grief assessed using the Inventory for Complicated Grief. To validate the trajectory that corresponded to prolonged grief, we examined the baseline predictors of these trajectories and their relationship with functional impairment. Results We found three distinct trajectories of grief reactions. One of these trajectories (13.8%) showed high and sustained grief reactions that persisted for almost 7.5 years after the death. Participants with prolonged grief showed greater functional impairment [relative risk ratio (RRR) = 0.82, 95% confidence interval (CI): 0.70 to −0.97; p = 0.02] and higher self-reported depression (RRR = 1.21, 95% CI 1.09 to 1.96; p = 0.001) than participants whose grief reactions subsided over time. The original PCBD (requiring 6 criterion C symptoms) criteria correctly identified cases (57.9–94.7%) with perfect specificity (100%) but low to high sensitivity (5.6–81.3%); however, its sensitivity increased when revising criterion C to require ⩾3 (45.5–94.1%). The dimensional approach showed high sensitivity (0.50–1) and specificity (0.787–0.97). Conclusions We recommend revisions to the PCBD criteria, which are overly restrictive and may exclude cases with clinically significant grief-related distress and impairment. In the meantime, clinicians need to monitor grief symptoms over time using available dimensional approaches to reduce the burden of grief.

scholarly journals Performance of DSM-5 Persistent Complex Bereavement Disorder Criteria in a Community Sample of Bereaved Military Family Members

2016 ◽  
Vol 173 (9) ◽  
pp. 919-929 ◽  
Author(s):  
Stephen J. Cozza ◽  
Joscelyn E. Fisher ◽  
Christine Mauro ◽  
Jing Zhou ◽  
Claudio D. Ortiz ◽  
...  
Keyword(s):  
Community Sample ◽  
Family Members ◽  
Military Family ◽  
Dsm 5 ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

Abhängigkeitspotenzial und andere Risiken von Opioidanalgetika im Alter

2017 ◽  
Vol 63 (2) ◽  
pp. 99-114 ◽  
Author(s):  
Dirk K. Wolter
Keyword(s):  
Adverse Effects ◽  
Psychische Störungen ◽  
Opioid Analgesics ◽  
Alte Menschen ◽  
Dsm 5 ◽  
Icd 10

Zusammenfassung. Zielsetzung: Übersicht über Suchtpotenzial und andere Risiken von Opioidanalgetika im höheren Lebensalter. Methodik: Narrativ review. Literaturrecherche in PubMed (Suchbegriffe: opioid analgesics UND abuse; opioid analgesics UND dependence; opioid analgesics UND addiction; opioid analgesics UND adverse effects; jeweils UND elderly) sowie aktuellen einschlägigen Standardwerken; Auswahl nach altersmedizinischer Relevanz und Aktualität. Ergebnisse: Die Verordnung von Opioidanalgetika (OA) hat in den letzten 25 Jahren massiv zugenommen, die weitaus meisten Verordnungen entfallen auf alte Menschen und Menschen mit chronischen Nicht-Tumorschmerzen (CNTS). Die diagnostischen Kriterien für die Opiatabhängigkeit in ICD-10 und DSM-5 sind für die OA-Behandlung von CNTS ungeeignet. Bei langfristiger OA-Behandlung bei CNTS kann eine spezifische Form von Abhängigkeit entstehen, die nicht mit der illegalen Opiat-(Heroin-)Sucht gleichzusetzen ist. Vorbestehende Suchterkrankungen und andere psychische Störungen sind die wesentlichsten Risikofaktoren. Weitere Nebenwirkungen sind zu beachten. Schmerztherapie bei Suchtkranken stellt eine besondere Herausforderung dar. Schlussfolgerungen: Die Anwendung von OA bei CNTS verlangt eine sorgfältige Indikationsstellung. Die besondere Form der Abhängigkeit von OA ist nicht ausreichend erforscht und wird zu wenig beachtet.

Sign in / Sign up

Export Citation Format

Share Document