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. 2007 Jun;6(2):102-7.

Validity of the bereavement exclusion criterion for the diagnosis of major depressive episode

Sidney Zisook  1 , Katherine Shear, Kenneth S Kendler
Affiliations

Validity of the bereavement exclusion criterion for the diagnosis of major depressive episode

Sidney Zisook et al. World Psychiatry. 2007 Jun.

Abstract

Since the publication of DSM-III in 1980, the official position of American psychiatry has been that the presence of bereavement is an exclusion criterion for the diagnosis of a major depressive episode (MDE). However, the empirical validity of this exclusion has not been well established. As DSM-V is now being planned, it is timely to reexamine the bereavement exclusion, particularly in the light of new evidence since the last reviews of this subject. This paper evaluates the relative validity of two competing hypotheses: 1) the bereavement exclusion for the diagnosis of MDE is not valid because, using validating criteria, bereavement related depression (BRD) within the first two months after the death of a loved one resembles non-bereavement related depression (SMD); 2) the bereavement exclusion for the diagnosis of MDD is valid because, using validating criteria, BRD within the first two months after the death of a loved one does not resemble SMD. The prevailing evidence more strongly supports Hypothesis 1 than Hypothesis 2. Thus, the bereavement exclusion for the diagnosis of MDE may no longer be justified.

Keywords: DSM-V; Major depression; bereavement; diagnostic validators.

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