II. Diagnosis: Complicated Grief Reaction

  1. General
    1. Symptoms present for 6 months
    2. Results in functional Impairment
    3. Based on expert opinion (Not defined in DSM IV)
  2. Major Criteria (3 of the following, daily or severe)
    1. Intrusive thoughts about deceased
    2. Yearning for deceased
    3. Searching for deceased
    4. Excessive loneliness
  3. Minor Criteria (4 of the following, daily or severe)
    1. Lacks sense of purpose
    2. Decreased emotional responsiveness
    3. Disbelief about the death
    4. Life feels meaningless
    5. Sense that part of self has died
    6. Lost sense of trust of control
    7. Performs harmful behaviors associated with deceased
    8. Excessive irritability or anger about death

III. Clinical communication strategies

  1. Effective strategies
    1. Use the deceased name in place of they or them below
    2. Acknowledge their death
      1. "I am sorry that they are gone"
    3. Talk about the deceased and memories
      1. "What are you remembering about them today"
    4. Bring closure on their death
      1. "...questions about final illness or treatment?"
    5. Talk about grief feelings
      1. "How has their death affected you"
  2. Harmful strategies to avoid
    1. Avoid being too casual or aloof
      1. Quick "Call me" or "How are you"
    2. Avoid pat answers
      1. "They are happy now" or "It is God's will"
    3. Avoid disallowing patient's feelings
      1. "You should be getting over this by now"

IV. Management: Complicated Grief Reaction

  1. Cognitive behavior therapy (Traumatic grief therapy)
  2. Selective Serotonin Reuptake Inhibitor (SSRI)

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Related Studies

Ontology: Bereavement (C0005119)

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, シベツNOS, シベツ, 死別反応, シベツハンノウ
Swedish Smärtsam förlust
Czech smrt blízké osoby, ztráta blízké osoby, Úmrtí, Úmrtí NOS, Reakce na úmrtí
Finnish Surutyö
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
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