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Bereavement Exclusion Analysis

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The following article discusses the controversy around introduction of the bereavement exclusion in the DSM-III, why it has been removed from the DSM-5, and the continuous confusion around this issue (Zisook, Pies, & Iglewicz, A, 2013). The bereavement exclusion was initially added to the DSM-III to identify bereavement from major depression. The decision to add this exclusion was based on studies initiated by Paula Clayton and her colleagues from Washington University. According to Zisook et al. (2013), Clayton’s studies found that many of the subjects that were experiencing bereavement showed symptoms that are generally associated with major depressive disorder (Zisook et al., 2013). The difference between the two was that individual’s experiencing …show more content…
“The work group was very convinced that major depressive symptoms occurring in the context of bereavement were more similar to than different from other, non-bereavement related MDE’s (Zisook et al., 2013, p.390)”. The workgroup suggested that symptoms of bereavement may trigger an MDE in vulnerable individuals and when this occurs the depression may be the same as other MDE’s. The workgroup then decided that limiting normal bereavement to two months is not feasible and therefore the DSM-5 states the following blurb about bereavement; “imposing a time limit on grief after bereavement is unjustified and counter therapeutic” (Zisook et al., 2013, p. …show more content…
Many believe that the removing this exclusion is the beginning of medicalizing grief which is a normal part of human life (Zisook et al., 2013). There are also fears that removing this exclusion will lead to an over diagnosis of MDD. In return there will possibly be an explosion in prescribing antidepressants (Zisook et al., 2013). Zisook et al. (2013) suggested that the major purpose of removing the bereavement exclusion was to remove challenges when diagnosing MDD and distinguishing grief versus symptoms of MDD (Zisook et al., 2013). On another note eliminating the bereavement exclusion opens another door to the same careful attention that anyone suffering from MDD deserves. This allows for the provider to provide support, education, hope, care and treatment to any person suffering from MDD. The team agreed that the risk of the patient missing a diagnosis of MDD is much greater than the risks of being given diagnosis of MDD accidentally (Zisook et al.,

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