Not an Onion Study: Loss of a Loved One Increases Risk of Psychological Distress

Rob Wipond
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When a loved one dies, some people are more likely to become very sad, drink more, and be diagnosed by mental health professionals as having psychiatric disorders, according to research published in the American Journal of Psychiatry. Columbia, Harvard and Boston University researchers examined 27,534 people from the National Epidemiologic Survey on Alcohol and Related Conditions who’d lost a loved one at some point in their lives, and correlated them to subsequent occurrences of psychiatric diagnoses. The researchers found that people who have lost a loved one are more likely to be diagnosed as having depression, posttraumatic stress, and other mood, phobia, anxiety and alcohol disorders, especially immediately following a death.

“Unexpected death is associated with heightened vulnerability for onset of virtually all commonly occurring psychiatric disorders that we assessed,” concluded the researchers. Although some of the associated psychiatric disorders actually only emerged many years after people had lost their loved ones, the researchers found that in most cases these diagnoses were meted out by doctors shortly after the loved one died. “For most disorders, a marked increase was observed in onset frequency in the time period during which the unexpected death occurred,” they wrote.

The researchers noted that the majority of people in the study who’d lost a loved one were never diagnosed with any mental disorders. However, a change in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders will make it more likely in future that people who’ve experienced the loss of a loved could be diagnosed with depression. DSM-IV had a “bereavement exclusion” that clarified to physicians that grieving the loss of a loved one was normal for up to two months and should not be identified and treated as clinical depression during that time, but that exclusion was removed from DSM-V. In addition, for longer-lasting bereavement, a new mental disorder called “Persistent Complex Bereavement Disorder” was added to DSM-V. Kenneth J. Doka commented on the rationale in a Huffington Post blog, noting that this “pathologizing of grief may be embraced by pharmaceutical companies, which may now see an emerging market of grievers open to the suggestion to consult a physician if they are struggling with a loss.”

In an editorial in the American Journal of Psychiatry accompanying the new study, Julie Kaplow and Christopher Layne described the study as “an essential first step” in helping physicians understand and mitigate the risks of “bereavement-related pathology” that evidently begin “as early as age 5.” Layne and Kaplow are co-developers of the Bereavement Risk and Resilience Index, the Persistent Complex Bereavement Disorder Checklist, and the Trauma and Grief Component Therapy for Adolescents.

The Burden of Loss: Unexpected Death of a Loved One and Psychiatric Disorders Across the Life Course in a National Study (Keyes, Katherine M. Keyes et al. Am J Psychiatry 2014;171:864-871. doi:10.1176/appi.ajp.2014.13081132)

Sudden Loss and Psychiatric Disorders Across the Life Course: Toward a Developmental Lifespan Theory of Bereavement-Related Risk and Resilience (Kaplow, Julie B. and Layne, Christopher M. Am J Psychiatry 2014;171:807-810. doi:10.1176/appi.ajp.2014.14050676)

Grief and the DSM: A Brief Q&A (Kenneth J. Doka, Huffington Post, May 29, 2013)

17 COMMENTS

    • Humanbeing,

      My husband died unexpectedly at the age of 46, just three years ago now, and he made a nightmare of our finances before he passed, so I lost all my home equity and our home. But, I’ve spoken with a lot of people who’ve told me divorce stories that were every bit as bad, if not worse, than what I went through – at least I got to keep the kids, people were kind and empathetic, and I got survivor’s benefits for a bit. Divorce can definitely be worse, you have every right to feel saddened and wronged.

      I’m sorry for what you went through. Write / journal (get the anger OUT of you), exercise, eat healthy, paint or create somehow (again, get the anger OUT of you), meditate, get a manicure, work hard, play hard, do what you need for YOU to heal. Try to think of this as YOUR time to be the most important person now, instead of lamenting on what you’ve lost (easier said than done, though, I know). And, trust me, you DON’T want to be put on the antidepressants.

  1. “Grieving” by the Pharmaceutical Companies is a great way to sell more drugs!

    Why can’t I just be aloud to feel pain for my loss instead of being medicated by a $2.5 Trillion Health Care Industry that is prone to treat sorrow and loss as a mental disorder?

    Feeling loss is a natural human emotion…medicating loss is an American travesty!

  2. You make “grief” a “disease”, and the “mental illness” industry is going to make money. You make “grief” a childhood and adolescent “disease”, and the “mental illness” industry is going to make even more money. The DSM-5 removed “grief” as an exception to “disease”. Now it’s official. The buzzards can move in to collect. They’ve got a study in the American Journal of Psychiatry, and it conform to expectations. The funerary industry just went “mental”.

  3. “Not an Onion Study”……yes, most people not familiar with this kind of garbage would think it was some kind of (bad) joke. But there is a silver lining, as this was probably one of the most stupid moves in the percent past made by the psychiatric profession. I have found that when I explain this to people who are not in our movement, they agree that it is outrageous, and of course, that in most cases it could apply to them. In the long run, this self-serving lie the profession has promulgated helps us to take away their power.

  4. If memory serves, I’ve seen the figure here of $200K as an average income for psychiatrists, to ruin people’s lives with these incurable bereavement diagnoses.

    Personally, this depresses the daylights out of me, which perfectly exemplifies the old adage that Psychiatry produces the diseases it pretends to have the cure for.

  5. Wow, they actually got PAID to do this study? Morons! And they talk of “bereavement-related pathology,” as if someone’s supposed to just stay cheery as hell after a loss and any “negative emotions” are to be considered pathological.

    MORONS! (Did I say that already?)

    —- Steve

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