Grief, depression, and the DSM-5.
Grief, depression, and the DSM-5.
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悲伤、抑郁和 DSM-5。
DOI：
10.1097/01.pra.0000435037.91049.2f
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发表时间：
2013
影响因子：
1.9
通讯作者：
Iglewicz,Alana
中科院分区：
文献类型：
--
作者：
Zisook,Sidney;Pies,Ronald;Iglewicz,Alana
基于对现有最佳证据的审查，以及为临床医生提供机会以确保患者及其家属获得适当诊断和正确干预的重要性，而不一定受到某种程度上任意的2个月时间的限制，DSM-5工作组建议从重度抑郁症的诊断中消除“丧亲排除”（BE）。本文回顾了在DSM-III中创建BE的最初理由，未将BE纳入DSM-5的原因，以及持续争议的来源。作者认为，去除BE并不“医学化”或“病理化”悲伤，“污名化”丧亲之痛的人，意味着悲伤在2周后演变为抑郁症，对悲伤施加任何时间限制，或意味着应该开抗抑郁药物。相反，消除BE为任何患有重度抑郁症的人提供了同样的仔细关注，并允许临床医生提供适当的教育，支持，希望，护理和治疗。（Journal of Psychiatric Practice 2013; 19：386-396）
Based on a review of the best available evidence and the importance of providing clinicians an opportunity to ensure that patients and their families receive the appropriate diagnosis and the correct intervention without necessarily being constrained by a somewhat arbitrary 2-month period of time, the DSM-5 Task Force recommended eliminating the “bereavement exclusion”(BE) from the diagnosis of major depressive disorder. This article reviews the initial rationale for creating a BE in DSM-III, reasons for not carrying the BE into DSM-5, and sources of continued controversy. The authors argue that removing the BE does not “medicalize” or “pathologize” grief,“stigmatize” bereaved persons, imply that grief morphs into depression after 2 weeks, place any time limit on grieving, or imply that antidepressant medications should be prescribed. Rather, eliminating the BE opens the door to the same careful attention that any person suffering from major depressive disorder deserves and allows the clinician to provide appropriate education, support, hope, care, and treatment.(Journal of Psychiatric Practice 2013; 19: 386–396)