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First, the assignment of an arbitrary time period where bereavement is "normal" and after that particular time frame it becomes dysfunctional has no empirical basis. Secondly, the exclusion criteria in the DSM -- IV -- TR most likely resulted in individuals who would have benefited from treatment not receiving treatment for their depressive symptoms until this particular time period expired. That is inexcusable. Finally, the research indicates that there may be some minor differences between bereavement and major depression; however, the two are not often clinically distinguishable aside from noting that in one case there was a loss of a loved one and yet individuals who are experiencing severe symptoms in bereavement are at risk for more serious issues. By eliminating the exclusion criteria clinicians are given much-needed room to treat their patients in individualized basis as opposed to a standardized cookie-cutter protocol.
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Corruble, E., Chouinard, V.A., Letierce, A., Gorwood, P.A., & Chouinard, G. (2009). Is DSM-
IV bereavement exclusion for major depressive episode relevant to severity and pattern of symptoms? A case-control, cross-sectional study. Journal of Clinical Psychiatry, 70(8), 1091-1097.
Horwitz, A.V., & Wakefield, J.C. (2007). The loss of sadness: How psychiatry transformed normal sorrow into depressive disorder. New York: Oxford University Press.
National Institute of Mental Health. (2011). NIMH Research Domain Criteria (RDoC). Retrieved
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Wakefield, J.C., & First, M.B. (2012). Validity of the bereavement exclusion to major depression: Does the empirical evidence support the proposal to eliminate the exclusion in DSM"5" World Psychiatry, 11(1), 3-10.
Zisook, S., Shear, K., & Kendler, K.S. (2007). Validity of the bereavement exclusion criterion for the diagnosis of major…
References
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders
(3rd Ed.). Washington DC: Author.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders
(4th Ed. -- Text Revision). Washington DC: Author.
on April 16, 2014 from http://www.nimh.nih.gov/research-priorities/rdoc/nimh-research-domain-criteria-rdoc.shtml.
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