Complicated grief and related bereavement issues for DSM-5

M. Katherine Shear, Naomi Simon, Melanie Wall, Sidney Zisook, Robert Neimeyer, Naihua Duan, Charles Reynolds, Barry Lebowitz, Sharon Sung, Angela Ghesquiere, Bonnie Gorscak, Paula Clayton, Masaya Ito, Satomi Nakajima, Takako Konishi, Nadine Melhem, Kathleen Meert, Miriam Schiff, Mary Frances O'Connor, Michael FirstJitender Sareen, James Bolton, Natalia Skritskaya, Anthony D. Mancini, Aparna Keshaviah

Research output: Contribution to journalReview articlepeer-review

698 Scopus citations


Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally, grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence, some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This article focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders. Depression and Anxiety, 2011.

Original languageEnglish (US)
Pages (from-to)103-117
Number of pages15
JournalDepression and Anxiety
Issue number2
StatePublished - Feb 2011


  • DSM-5
  • complicated grief
  • diagnostic criteria
  • dimensional assessment
  • stress response disorder


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