Affiliation:
1. Washington University School of Medicine, St. Louis, Missouri.
2. Malcolm Bliss Mental Health Center, St. Louis, Missouri.
3. Washington University School of Medicine.
Abstract
Previous studies have shown that bereaved people respond to their loss with a set of psychological symptoms which are in many instances indistinguishable from depressive illness, but accepted by them and their environment as normal (1,3,5). On the other hand, patients with primary affective disorder experience their condition as a “change”, “not usual self” (7), which leads them to seek help, and in this way they define themselves as patients. A comparison of frequencies of psychiatric symptoms between depressed 34, and bereaved 34, subjects matched for sex and age shows that hospitalized depressed subjects have more symptoms — 15 — than bereaved subjects (7). However, there is enough overlap that, on the basis of symptoms, the two groups cannot be differentiated satisfactorily for research purposes. In psychiatry, most diagnostic criteria are arbitrary. If they are set narrow some patients with a mild form of illness are excluded, while if broad criteria are employed persons with other conditions or no illness at all are included. For research purposes if the symptoms of depression occur only after the death of a near relative the subjects should not be included in the group diagnosed as suffering from primary affective disorder.
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