Gender differences in the effects of bereavement-related 
psychological distress in health outcomes

Chen, J. H.; Bierhals, Andrew J.; Prigerson, Holly G.; Kasl, Stanislav V.; Mazure, Carolyn M.; Jacobs, Selby

doi:10.1017/s0033291798008137

Cited by 208 publications

(173 citation statements)

References 21 publications

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…Complicated grief, a well-defined syndrome of grief manifestations persisting >6 months [24,25], occurs in ∼10% of bereaved relatives [26,27] and adversely affects quality of life [25,[28][29][30][31]. The persistent manifestations may include intense yearning for the deceased, a sense of disbelief regarding the death, anger, bitterness, intrusive preoccupying thoughts of the deceased, avoidance of reminders of the loss and difficulty in moving on with life [24,25].…”

Section: Introductionmentioning

confidence: 99%

Complicated grief after death of a relative in the intensive care unit

Kentish-Barnes¹,

Chaize²,

Seegers³

et al. 2015

Eur Respir J

265

208

View full text Add to dashboard Cite

An increased proportion of deaths occur in the intensive care unit (ICU).We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months.Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives).End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements. @ERSpublications End-of-life care and communication in the ICU are associated with the prevalence of complicated grief http://ow.ly/DCqjB

show abstract

Section: Introductionmentioning

confidence: 99%

Complicated grief after death of a relative in the intensive care unit

Kentish-Barnes¹,

Chaize²,

Seegers³

et al. 2015

Eur Respir J

265

208

View full text Add to dashboard Cite

show abstract

“…Age has also yielded conflicting results: some studies have shown younger bereaved subjects being more likely to develop MDD [20,30] , while others have reported an absence of association of age with MDD [21-23, 28, 37, 38] . Women have also been shown to be more likely [24,38,39] or as likely to develop MDD [20-23, 28, 30, 37, 40] compared to men after the loss of a loved one. These differences may be due to varying study designs and sample populations.…”

Section: Predictors Of Major Depression In Bereavementmentioning

confidence: 99%

Beyond DSM-IV Bereavement Exclusion Criterion E for Major Depressive Disorder

Chouinard

2011

Psychother Psychosom

View full text Add to dashboard Cite

ticle, we propose to revise DSM-IV bereavement exclusion and keep the V code for bereavement as suggested by Paula Clayton [19] . In addition, in the event that criterion E is deleted, we believe that criterion A for major depression should be revised to require at least 7 of the 9 criterion A inclusion symptoms for MDE in all types of MDD, which would satisfy the concerns raised by Lichtenberg and Belmaker [3] and Bech [4] about the overinclusiveness of criterion A, leading to overdiagnosis of MDE. Adjusting the number of inclusion symptoms of criterion A reinforces the dimensional approach to depression initiated by the DSM-III (1980) and DSM-III-R (1987). To avoid a 'single catchall entity' diagnosis of MDE [3] , depression subtypes can be used, including bereavement depression. Now is the time to reevaluate depression subtypes and MDD, and allow subtypes for some of the welldefined stress event depressions. Bereavement and Major DepressionBereavement is known to be associated with high rates of MDE and of other major depressive syndromes [20][21][22][23][24][25][26][27][28][29] . Major depression is common during the first year of bereavement, with higher rates earlier in bereaveThere are two issues facing the DSM-V in the revision of the criteria for major depressive disorder (MDD), the first being the concept of DSM-III [1] criterion A inclusion symptoms for major depressive episode (MDE), which has recently been addressed by Fava et al. [2] , Lichtenberg and Belmaker [3] and Bech [4] . The second concerns bereavement criterion E, which often leads to exclusion from MDE. The rationale behind criterion E was that symptoms of bereavement-related sadness resemble those of major depression without the presence of MDD. Bereavement is the only stressful life event (SLE) which is an exclusion criterion for a DSM axis I diagnosis, unless depressive symptoms associated with bereavement last longer than 2 months or meet the bereavement descriptive E criterion for major depression. Several authors have questioned the validity of excluding bereavement from major depression when all other inclusion criteria are met [5][6][7][8] . SLE, including bereavement, have been found to contribute to, initiate and maintain MDD [9][10][11][12][13][14][15][16][17] . More recently, we reported that DSM-IV bereavement-excluded subjects were more severely depressed than MDE subjects without bereavement, and at least as severely depressed as MDE subjects with bereavement [18] . At this time, the DSM-V is proposing to delete bereavement exclusion criterion E for major depression (www.DSM5.org). In the present ar-

show abstract

“…Widows have poorer physical health and greater unintentional weight loss over a three-year follow-up (Wilcox et al 2003) and widows experiencing traumatic grief are at greater risk of long-term ill health such as cancer or heart attack (Chen et al 1999). Health service use may increase significantly with complicated grief reactions (Ray & Prigerson 2006).…”

Section: Complications Of Griefmentioning

confidence: 99%

Progress in understanding grief, complicated grief, and caring for the bereaved

Love

2007

Contemporary Nurse

View full text Add to dashboard Cite

Grief occurs with loss of symbolically important connections and involves intense emotional reactions and changes to our experiences of self, the world, and the future.Individual responses reflect factors such as personality and life history, social context and cultural practices, and the symbolic magnitude of the loss. Grieving can be a relatively slow and uneven process, so applying prescriptive stages or goals to individuals' experiences can be unhelpful. Although most people are resilient in the face of loss and do not require special interventions, health professionals can contribute by empathic use of communication skills to facilitate the grieving process.A minority will struggle with their grief and experience prolonged, intense, or problematic reactions. Psychiatric comorbidities including depression and anxiety disorders can occur, and a distinct diagnosis of complicated grief disorder has been proposed. Health professionals can identify complicated grief reactions and ensure patients receive specialised treatment, including intensive grief therapy and medication where indicated. Assessment methods are summarised to assist health professionals in providing a continuum of care for those who are grieving.

show abstract

Gender differences in the effects of bereavement-related psychological distress in health outcomes

Abstract: The results suggest that there are gender differences in the levels of psychological symptoms resulting from bereavement and in their effects on subsequent mental and physical health for widows and widowers.

Cited by 208 publications

References 21 publications

Complicated grief after death of a relative in the intensive care unit

Complicated grief after death of a relative in the intensive care unit

Beyond DSM-IV Bereavement Exclusion Criterion E for Major Depressive Disorder

Progress in understanding grief, complicated grief, and caring for the bereaved

Contact Info

Product

Resources

About