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Disturbed grief: prolonged grief disorder and persistent complex bereavement disorder

2017; BMJ; Linguagem: Inglês

10.1136/bmj.j2016

0959-8138

Paul A. Boelen, Geert E. Smid,

Palliative Care and End-of-Life Issues

Each individual's grief process is unique.The concept of stages of grief occurring in a specific order is a popular, yet inadequate representation of what grieving people go through. 1 Traditional models developed to understand grief therefore often unhelpfully suggest that all bereaved individual do, and even should, follow the same process towards recovery from loss.The newer grief task model 2 offers a more neutral framework to describe normal and disturbed grief.The model proposes that normal grief is the successful achievement of certain "grief tasks," whereas complications in managing these tasks might indicate disturbed grief.There is no recommended or specific order in which to achieve these tasks.Grief tasks include: to accept the reality of the loss; to process the associated pain; to adjust to a world without the deceased; and to find an enduring connection with the deceased in the midst of embarking on a new life.The model also describes challenges faced following losses other than bereavement (Box 'Grief following events other than bereavement').Doctors from any specialty can identify bereaved patients who are struggling for longer, or more severely than most.Defining when this grief becomes disturbed or pathological is difficult, and has been the subject of recent classification and debate (box 1).