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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bereavement related and non-bereavement related depressions: A comparative field study
Journal of Affective Disorders, Volume 112, No. 1-3, Year 2009
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Description
Background and Method: In the otherwise a-theoretical diagnostic manual, the DSM-III and IV bereavement exclusion for the diagnosis of major depression (MDD) stands out as the sole exception to the rule. No other life event excludes the diagnosis of any other axis I disorder. Since this diagnostic convention has important diagnostic and treatment implications, it is important to evaluate the validity of this exception. By comparing multiple features of bereavement related to non-bereavement related MDD, this prospective community study critically evaluates the validity of the bereavement exclusion. Results: The prevalence of conditional criteria was common in the total sample (N = 685) and did not differ between bereaved and non-bereaved groups. The global 'symptom profile' of depressed individuals was similar in both groups. 'Duration' was found to be longer in the bereaved group. Among all conditional criteria required by DSM-IV to accept bereavement-related episodes under the category of MDD, only 'marked dysfunction' predicted treatment. Neither the 'four conditional symptoms' nor the 'duration' criterion predicted marked dysfunction. The 'risk for recurrence' was similar whether the first episode was bereavement related or not. Limitations: 'Psychotic symptoms' were not assessed, and 'marked dysfunction' was not assessed on a continuous scale. The number of DSM-IV excluded episodes was too small to allow for generalization. Conclusion: Our results suggest that the conditional criteria do not seem to serve the purpose of the originators of the bereavement exclusion criteria. The 'conditional symptoms' and the 'duration' criterion seem not to be markers of severity. We propose that the descriptive and etiologically neutral approach the DSM presumes in reaching a diagnosis should be applied in the case of MDD until more convincing data point to the contrary. © 2008 Elsevier B.V. All rights reserved.
Authors & Co-Authors
Karam, Elie Georges
Lebanon, Al Koura
University of Balamand
Lebanon, Beirut
Saint George Hospital University Medical Center
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
Cordahi-Tabet, C.
Lebanon, Al Koura
University of Balamand
Lebanon, Beirut
Saint George Hospital University Medical Center
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
Alam, Donna
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
Shamseddeen, Wael A.
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
Chatila, Yasmine
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
Mneimneh, Zeina N.
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
United States, Ann Arbor
University of Michigan, Ann Arbor
Salamoun, Mariana M.
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
Hamalian, Marc
Lebanon, Beirut
Institute for Development, Research, Advocacy and Applied Care, Beirut
Statistics
Citations: 62
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1016/j.jad.2008.03.016
ISSN:
01650327
Research Areas
Mental Health
Study Design
Cross Sectional Study
Cohort Study