Prigerson Holly G, Kakarala Sophia, Gang James, Maciejewski Paul K
Cornell Center for Research on End-of-Life Care, Weill Cornell Medicine, New York, NY 10021, USA; email:
Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA.
Annu Rev Clin Psychol. 2021 May 7;17:109-126. doi: 10.1146/annurev-clinpsy-081219-093600. Epub 2021 Feb 1.
Prolonged grief disorder (PGD) is a diagnostic entity now included in the (ICD-11) and soon to appear in the , fifth edition, text revision (DSM-5-TR). A characteristic feature of PGD is distressing, disabling yearning that persists a year or more after the loss. Other characteristic symptoms include disbelief and lack of acceptance of the loss, emotional detachment from others since the loss, loneliness, identity disturbance, and sense of meaninglessness. In this review, we detail psychiatric views on grief and their evolution over the twentieth century. We then discuss the development of diagnostic formulations for disordered grief, which culminated in PGD's status as a mental disorder in the DSM. After summarizing recent evidence that may suggest that PGD is linked to the neural reward system, we suggest further areas of research. In particular, we note the need for studies that extend the evidence base concerning PGD across cultural and sociodemographic boundaries and that investigate novel treatments.
持续性悲伤障碍(PGD)是一种诊断实体,现已被纳入《国际疾病分类第11版》(ICD - 11),并即将出现在《精神疾病诊断与统计手册》第五版修订版(DSM - 5 - TR)中。PGD的一个特征是令人痛苦、使人丧失能力的思念,这种思念在丧失事件发生一年或更长时间后仍持续存在。其他特征性症状包括对丧失的怀疑和无法接受、自丧失事件后与他人情感疏离、孤独、身份认同紊乱以及无意义感。在本综述中,我们详细阐述了二十世纪以来精神病学对悲伤的看法及其演变。然后我们讨论了对异常悲伤的诊断表述的发展,这最终使PGD在《精神疾病诊断与统计手册》中成为一种精神障碍。在总结了近期可能表明PGD与神经奖赏系统有关的证据后,我们提出了进一步的研究领域。特别是,我们指出需要开展跨文化和社会人口统计学界限扩展PGD证据基础的研究,以及研究新型治疗方法的研究。