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悲伤:病因、症状与管理。

Grief: Aetiology, Symptoms and Management.

机构信息

Macedonian Academy of Sciences and Arts, Skopje, N Macedonia.

出版信息

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Oct 26;42(2):9-18. doi: 10.2478/prilozi-2021-0014.

DOI:10.2478/prilozi-2021-0014
PMID:34699700
Abstract

Grief is a process provoked as a response to different losses, such as death, loss of job, relationship breakdown, some unexpected life events and changes, etc. The experiences of loss and bereavement are very individual. Even though loss is expected, the person feels traumatized, especially if death is provoked by violence, natural disasters, or war. This pandemic, like other disasters (wars, tsunami, earthquakes, floods, etc.) has provoked intensive reactions of grief, reactions that could persist for years. The core symptoms of grief are described in the ICD-11 and DSM-5 manuals. The term "complicated grief" in the medical sense refers to a superimposed process that alters grief and modifies its course for the worse. Prolonged grief disorder (PGD) is characterized by normal grief symptoms, but these are symptoms that remain too intense for too long of a period. This article is a review of the manifestations and duration of grief in different occasions, and it is based on over 50 published papers, and discoveries in the Medline and Psych-Net databases. Commonly described reactions to grief are: shock, disbelief or denial, a high level of anxiety, distress, anger, sadness, insomnia, and a loss of appetite. As predictors for a high/slow decreasing trajectory of grief process are: female gender, reported symptoms of depression before the traumatic event, and higher scores on avoidance. However, grief is transient, even as we are is in the midst of its clutches. People should expect to fluctuate between moments of sadness and mourning, and moments of acceptance, or even happiness for being alive. Researchers suppose that when a crisis passes; most people will be able to bounce back and move on with their lives.

摘要

悲伤是一种对不同损失的反应过程,如死亡、失业、关系破裂、一些意外的生活事件和变化等。失去和悲伤的经历是非常个人化的。即使是预期的损失,人们也会感到创伤,尤其是如果死亡是由暴力、自然灾害或战争引起的。这场大流行,就像其他灾难(战争、海啸、地震、洪水等)一样,引发了强烈的悲伤反应,这种反应可能会持续多年。悲伤的核心症状在 ICD-11 和 DSM-5 手册中有所描述。医学意义上的“复杂悲伤”一词是指一种叠加的过程,它改变了悲伤,并使其恶化。延长的悲伤障碍(PGD)的特征是正常的悲伤症状,但这些症状过于强烈,持续时间过长。本文综述了不同情况下悲伤的表现和持续时间,参考了 50 多篇已发表的论文,以及 Medline 和 Psych-Net 数据库中的发现。通常描述的悲伤反应有:震惊、不相信或否认、高度焦虑、痛苦、愤怒、悲伤、失眠和食欲不振。对悲伤过程的高/低下降轨迹的预测因素是:女性性别、在创伤事件前报告的抑郁症状,以及回避得分较高。然而,悲伤是短暂的,即使我们处于它的控制之下。人们应该预期会在悲伤和哀悼的时刻之间波动,以及接受的时刻,甚至是活着的快乐时刻。研究人员假设,当危机过去时,大多数人将能够恢复并继续他们的生活。

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