II. Diagnosis: Complicated Grief Reaction
-
General
- Symptoms present for 6 months
- Results in functional Impairment
- Based on expert opinion (Not defined in DSM IV)
- Major Criteria (3 of the following, daily or severe)
- Intrusive thoughts about deceased
- Yearning for deceased
- Searching for deceased
- Excessive loneliness
- Minor Criteria (4 of the following, daily or severe)
- Lacks sense of purpose
- Decreased emotional responsiveness
- Disbelief about the death
- Life feels meaningless
- Sense that part of self has died
- Lost sense of trust of control
- Performs harmful behaviors associated with deceased
- Excessive irritability or anger about death
III. Clinical communication strategies
- Effective strategies
- Use the deceased name in place of they or them below
- Acknowledge their death
- "I am sorry that they are gone"
- Talk about the deceased and memories
- "What are you remembering about them today"
- Bring closure on their death
- "...questions about final illness or treatment?"
- Talk about grief feelings
- "How has their death affected you"
- Harmful strategies to avoid
- Avoid being too casual or aloof
- Quick "Call me" or "How are you"
- Avoid pat answers
- "They are happy now" or "It is God's will"
- Avoid disallowing patient's feelings
- "You should be getting over this by now"
- Avoid being too casual or aloof
IV. Management: Complicated Grief Reaction
- Cognitive behavior therapy (Traumatic grief therapy)
- Selective Serotonin Reuptake Inhibitor (SSRI)
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| Definition (MEDLINEPLUS) |
Bereavement is the period of grief and mourning after a death. When you grieve, it's part of the normal process of reacting to a loss. You may experience grief as a mental, physical, social or emotional reaction. Mental reactions can include anger, guilt, anxiety, sadness and despair. Physical reactions can include sleeping problems, changes in appetite, physical problems or illness. How long bereavement lasts can depend on how close you were to the person who died, if the person's death was expected and other factors. Friends, family and faith may be sources of support. Grief counseling or grief therapy is also helpful to some people. NIH: National Cancer Institute |
| Definition (MSH) | Refers to the whole process of grieving and mourning and is associated with a deep sense of loss and sadness. |
| Definition (CSP) | process of grieving and mourning; associated with a deep sense of loss and sadness. |
| Concepts | Mental Process (T041) |
| MSH | D001601 |
| SnomedCT | 192047002, 138181004, 225616005, 160850004, 3763000 |
| English | Bereavement, Bereavement NOS, Reaction after;bereavement, bereavement, Bereavements, Bereavement (finding), Bereavement reaction, bereavement reaction |
| Spanish | reacción de duelo, Duelo NEOM, reacción de congoja, congoja, Reacción de duelo, Aflicción, Desamparo, Desconsuelo, Tristeza, Pena, Pérdida, Congoja, Consternación, Duelo |
| Dutch | sterfgeval NAO, rouwreactie, rouw, Rouw, Rouwverwerking |
| French | Deuil SAI, Deuil (perte), Réaction suit à un deuil, Deuil |
| German | Trauerreaktion NNB, Trauerreaktion, Trauerreaktionen, Trauerarbeit, Trauern |
| Italian | Lutto NAS, Reazione di lutto, Lutto |
| Portuguese | Perda de ente querido NE, Reacção à perda de ente querido, Tristeza, Perda, Luto, Consternação |
| Japanese | 死別ＮＯＳ, 死別, ｼﾍﾞﾂNOS, ｼﾍﾞﾂ, 死別反応, ｼﾍﾞﾂﾊﾝﾉｳ |
| Swedish | Smärtsam förlust |
| Czech | smrt blízké osoby, ztráta blízké osoby, Úmrtí, Úmrtí NOS, Reakce na úmrtí |
| Finnish | Surutyö |
| Russian | POTERIA, UTRATA, ПОТЕРЯ, УТРАТА |
| Croatian | Not Translated[Bereavement] |
| Polish | Smutek, Żal, Uczucie straty |
| Hungarian | Gyász, Gyász k.m.n., Gyászreakció |
| Norwegian | Tap, Sorgtap |
Ontology: Grief reaction (C0018235)
| Definition (OMS) | Suffering and distress associated with loss. |
| Definition (CCC) | Feeling of great sorrow |
| Definition (MSH) | Normal, appropriate sorrowful response to an immediate cause. It is self-limiting and gradually subsides within a reasonable time. |
| Definition (CSP) | sorrowful response to an immediate cause; self-limiting and gradually subsides within a reasonable time. |
| Concepts | Mental Process (T041) |
| MSH | D006117 |
| ICD10 | F43.2 |
| SnomedCT | 279644004, 74506000, 224966005, 192047002, 192416004, 224965009 |
| LNC | MTHU013236 |
| English | Grief reaction, Grief, Griefs, Normal grief reaction to life event, grieving, bereavement without complications, aggrieved, bereavement without complications (diagnosis), mournful, grieving (symptom), grief reaction (diagnosis), grief reaction, rndx grieving, rndx grieving (diagnosis), Reaction after;grief, mourn, bereavement, grief reactions, sorrow, mourning, Feeling grief (finding), [X]Grief reaction, Grieving, Grief observations, Normal bereavement reaction, Normal grief reaction, Feeling grief, Grief finding (finding), Grief finding, grief, grief; reaction, reaction; grief, Normal grief reaction (life event - finding), Normal grief reaction, life event (finding), Normal grief reaction to life event (finding) |
| Spanish | reacción de duelo normal ante evento de la vida (hallazgo), reacción de duelo normal ante evento de la vida, hallazgo relativo al duelo, reacción de duelo normal, evento de la vida, reacción de duelo normal, evento de la vida (hallazgo), reacción de congoja, Reacción de pesar, Dolor Moral, Luto, Pesadumbre, duelo - observaciones, hallazgo relativo al duelo (hallazgo), hallazgo relacionado con el duelo (hallazgo), hallazgo relacionado con el duelo, Pesar |
| Swedish | Sorg |
| Czech | smutek, Zármutek v reakci na určitou událost |
| Finnish | Suru |
| Russian | PECHAL', ПЕЧАЛЬ |
| French | Affliction, Réaction à la perte d'une personne aimée, Chagrin, Peine, Tristesse |
| Croatian | ŽALOST |
| Portuguese | Reacção de luto, Dor Moral, Pesar |
| Italian | Reazione di afflizione, Cordoglio |
| German | Trauerreaktion, Gram, Kummer |
| Dutch | verdrietreactie, reactie; verdriet, verdriet; reactie, Rouw, Verdriet |
| Japanese | 悲嘆反応, ﾋﾀﾝﾊﾝﾉｳ |
| Polish | Żałoba, Reakcja żałoby |
| Hungarian | Gyászreakció |
| Norwegian | Sorg |
