Relation between duration and severity in bereavement-related depression
Article first published online: 23 SEP 2011
© 2011 John Wiley & Sons A/S
Acta Psychiatrica Scandinavica
Volume 124, Issue 6, pages 487–494, December 2011
How to Cite
Wakefield, J. C., Schmitz, M. F. and Baer, J. C. (2011), Relation between duration and severity in bereavement-related depression. Acta Psychiatrica Scandinavica, 124: 487–494. doi: 10.1111/j.1600-0447.2011.01768.x
- Issue published online: 14 NOV 2011
- Article first published online: 23 SEP 2011
- Accepted for publication August 17, 2011
Wakefield JC, Schmitz MF, Baer JC. Relation between duration and severity in bereavement-related depression.
Objective: Prolonged duration is commonly used as an indicator that bereavement-related depression (BRD) is pathological. DSM-IV replaced the traditional 1-year pathology cut-point by a 2-month cut-point. Yet, little evidence exists regarding the validity of these cut-points in indicating increased BRD severity. This study evaluated the validity of the 2-month and 1-year cut-points in differentiating less severe from more severe BRDs in a nationally representative U.S. sample.
Method: National Comorbidity Survey respondents with BRD’s (n = 152) lasting 0–8, 9–52 and >52 weeks were evaluated for depression severity using six severity indicators. Cut-point validity was established by discontinuities in severity levels between durations below and above the cut-point.
Results: Bereavement-related depressions of >52-week duration were significantly higher than 9- to 52-week BRDs on four of six severity indicators and on a cumulative overall severity measure of mean number of severity indicators per person, whereas ≤8-week and 9- to 52-week durational categories differed on one severity indicator and not on overall severity. Additional analyses using durations 0–12, 13–26, 27–52 and >52 weeks suggested that alternative <52-week cut-points also lack validity.
Conclusion: The traditional 1-year cut-point validly identifies increasing BRD severity; DSM’s 2-month cut-point does not. Duration does not indicate increasing BRD severity before 1 year. Research using the 2-month cut-point may yield misleading results.