Horowitz et al reported criteria for diagnosing a patient with the complicated grief disorder (CGD). Rather than emotionally bottoming out and then recovering the patient keeps spiralling down. The authors are from the University of California in San Francisco.


Criteria - both of the following:

(1) prolonged bereavement (>= 14 months after the loss)

(2) within the past month had >= 3 signs and symptoms associated with an interference in daily functioning


Bereavement is associated with the loss of:

(1) a spouse

(2) close relative

(3) intimate partner


Signs and symptoms reflecting intrusive thoughts, avoidance and/or a failure to adapt:

(1) intrusive thoughts, memories and/or fantasies about the lost person

(2) episodes of strong emotion related to memories of the lost person

(3) very strong wishes that the lost person was back

(4) feeling personally empty or very alone

(5) marked avoidance of persons, places, and/or situations that are reminders of the lost person

(6) marked interference with sleep

(7) marked loss of interest in work, social, intimate, and/or recreational activities


Differential diagnosis (may be mixed with CGD):

(1) anniversary reaction

(2) depression

(3) post-traumatic stress disorder


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