CG symptoms cause a great deal of distress and usually interfere with functioning and with the ability to find meaning and purpose in life. Many people with CG have suicidal thinking, sometimes at a level that is of concern. In our work, we have found the Inventory of Complicated

Grief (click here Prigerson et al, 1995) to be an excellent screening tool. However, there are Inhibitors,research,lifescience,medical currently no formal diagnostic criteria for this condition. Based on data20 and extensive clinical experience during three large NIMII-funded treatment studies, we proposed a criteria set21 (Table I) that was used in the deliberations by the DSM-5 workgroup. However, others have proposed alternatives22 and the DSM workgroup is proposing criteria be placed in the appendix (at www.DSM5.com) Inhibitors,research,lifescience,medical Additionally, they suggest that a bereavement disorder be considered a form of adjustment disorder, described by the text in Box 2. TABLE I. Proposed criteria for complicated grief.21 Box 2 At least 12 months following the death of a close relative or friend, the individual experiences intense yearning/longing for the deceased, intense sorrow, and emotional pain, or preoccupation with the deceased or the circumstances of the death. The person may also display difficulty Inhibitors,research,lifescience,medical accepting the death, intense anger over the loss, a diminished sense of self, a feeling that life is empty, or difficulty planning

for the future or engaging in activities or relationships. Mourning shows substantial cultural variation; the bereavement reaction must be out of proportion or inconsistent with cultural or religious norms. The main Inhibitors,research,lifescience,medical differential diagnostic considerations for CG include normal acute grief and major depression, and, if the death

is violent, PTSD. Differential diagnosis can be challenging because symptoms overlap and comorbidity is common with CG, especially among those Inhibitors,research,lifescience,medical who are help-seeking. The difference between CG and normal grief is related to the heightened intensity and longer persistence of acute grief symptoms and to the presence of complicating processes, as described above. One of the indicators of CG is that the family and friends of the sufferer are eager for them to get help. Often it is a family member or friend who finds the therapist or treatment isothipendyl program. This is a good indication that the grief symptoms are lasting longer than expected in the person’s cultural context. The symptoms of CG have some overlap with those of major depression, just as normal grief has some overlap with depression. CG symptoms are strongly centered on the loss. For example guilt is specifically related to letting the deceased down, whereas guilt in depression is pervasive and multifaceted. A grieving person maintains a sense of self-esteem and self-worth, whereas depressed people have lost faith in themselves.