The bereavement exclusion: Findings from a field study.
Author: Karam, E.G., Tabet, C.C. and Itani, L.A.
Source:
Psychiatric Annals, 43(6), pp.267-271.
Our group decided to investigate several aspects of the DSM-V bereavement exclusion (BE) criterion of depression in the community. We wanted to determine why we accept that a depression secondary to the breakup of a relationship, or failing in class, or going bankrupt is accepted as depression; yet, following what should be the most obvious precipitant - death of a loved one - is not. We undertook the first series of studies in a subpopulation of Lebanon that we will refer to as 'Lebanon targeted community studies' and then in a nationwide study, the LEBANON field study that we undertook in Lebanon. The study was conducted in four regions in Lebanon differentially exposed to war (Bejjeh, Kornet Shehwen, Ashrafieh, and Ain Remmaneh). The sample of the LEBANON study (n = 2,857) is a nationally representative, multi-stage clustered area probability sample of non-institutionalized adults (older than age 18 years) with no cognitive or physical impairment preventing them from participation. There was no statistically significant difference in the risk of recurrence whether the respondents’ first episode was BE or NBE. There were no differences in treatment rates in the Lebanon targeted-community studies between the BE and NBE episodes. Results from the LEBANON data show that among those with major depressive disorder (MDE) (n = 307), 34.5% attribute their MDE to bereavement, whereas 53.7% attribute it to other types of stressors.