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The Lancet, Volume 379, Issue 9816, Page 589, 18 February 2012. doi:10.1016/S0140-6736(12)60248-7
When should grief be classified as a mental illness? More often than is current practice, proposes the American Psychiatric Association in its forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Previous DSM editions have highlighted the need to consider, and usually exclude, bereavement before diagnosis of a major depressive disorder. In the draft version of DSM-5, however, there is no such exclusion for bereavement, which means that feelings of deep sadness, loss, sleeplessness, crying, inability to concentrate, tiredness, and no appetite, which continue for more than 2 weeks after the death of a loved one, could be diagnosed as depression, rather than as a normal grief reaction.
The death of a loved one can lead to a profound, and long-lasting, grieving process, which is movingly described in an essay by Arthur Kleinman in this week's Art of Medicine section. After his wife died, it took 6 months before Kleinman's feelings of grief became “less acute” in his own words, and almost a year on, he feels “sadness at times” and harbours “the sense that a part of me is gone forever…I am still caring for our memories. Is there anything wrong (or pathological) with that?”