Stewart T, Shields C R
Arch Phys Med Rehabil. 1985 Jul;66(7):447-50.
Grief is a normal reaction to the loss of physical function. Its symptoms, however, are often mistaken for major depressive episode and treatment may be inappropriate. Symptoms of grief include a preoccupation with the lost object (a limb, a function, a loved one), somatic distress, inappropriate behavior, hostility, and denial. Depression may be a manifestation of illness or drug therapy. Grief should be treated like a major depressive episode but without antidepressive medications. The first step in management of grief is the development of a proper therapeutic milieu which will encourage the reappearance of self worth. Once the milieu is established, specific rehabilitation problems can be addressed. In formulating a prognosis, it is important to consider the severity of the patient's disability, the premorbid psychologic make-up, and the type of family and community support available to the patient.
悲痛是对身体功能丧失的正常反应。然而，其症状常被误诊为重度抑郁发作，治疗可能并不恰当。悲痛的症状包括对失去的事物（肢体、功能、亲人）念念不忘、躯体不适、不当行为、敌意和否认。抑郁可能是疾病或药物治疗的一种表现。应像治疗重度抑郁发作一样治疗悲痛，但不使用抗抑郁药物。处理悲痛的第一步是营造一个合适的治疗环境，这将有助于恢复自我价值感。一旦建立了这种环境，就可以着手解决具体的康复问题。在制定预后时，重要的是要考虑患者残疾的严重程度、病前的心理构成以及患者可获得的家庭和社区支持类型。
