Rozenzweig A, Prigerson H, Miller M D, Reynolds C F
Department of Psychiatry, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Annu Rev Med. 1997;48:421-8. doi: 10.1146/annurev.med.48.1.421.
Spousal bereavement is a common event in later life and, not infrequently, an important cause of psychiatric and medical morbidity. Depression (along with suicide), anxiety, substance abuse, and symptoms of "complicated" grief are among the more important psychiatric sequelae of spousal bereavement. They may represent, in part, forms of abnormal reaction to the stress of loss and the challenges of adaption to becoming widowed. This paper summarizes current knowledge about the clinical phenomenology of the psychiatric sequelae to late-life attachment bereavement, some of the hypothesized antecedents of abnormal stress response to bereavement, psychobiologic correlates of bereavement-related depression, and the long-term course (including preliminary evidence on response to treatment with psychotherapy and antidepressant medication).
配偶丧亡是晚年生活中的常见事件，而且常常是精神疾病和躯体疾病发病的重要原因。抑郁（以及自杀）、焦虑、物质滥用和“复杂性”悲伤症状是配偶丧亡后较为重要的精神后遗症。它们可能部分代表了对丧失压力和适应丧偶挑战的异常反应形式。本文总结了目前关于晚年依恋丧亡后精神后遗症的临床现象学、丧亡异常应激反应的一些假定前因、丧亡相关抑郁的心理生物学关联以及长期病程（包括心理治疗和抗抑郁药物治疗反应的初步证据）的知识。
