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Am J Psychiatry 1991; 148:1346-1352
Copyright © 1991 by American Psychiatric Association
Depression through the first year after the death of a spouse
S Zisook and SR Shuchter
University of California, Department of Psychiatry, San Diego.
OBJECTIVE: This study assesses the frequency of depressive syndromes during
the first 13 months after the death of a spouse. METHOD: Men and women
whose spouses had recently died were identified through death certificate
records. These subjects completed a multidimensional questionnaire and were
interviewed 7-8 weeks (2 months) after the death. Follow-up questionnaires
were completed 7 and 13 months after the death. The questionnaires
contained specific items corresponding to DSM-III-R criteria for depressive
episodes as well as other widely used measures of depressive symptoms such
as the Zung Depression Scale and the Hopkins Symptom Checklist. RESULTS:
Eighty-four (24%) of 350 widows and widowers met criteria for depressive
episodes at 2 months, 72 (23%) of 308 did so at 7 months, and 46 (16%) of
286 did so at 13 months. At each time period, the prevalence was
substantially higher than the 4% rate of depressive episodes observed in a
comparison group of 126 subjects whose spouses were still living. Widows
and widowers most likely to meet criteria for depressive episodes 13 months
after the bereavement were younger, had past histories of major depression,
were still grieving 2 months after the loss, and met DSM-III-R criteria for
depressive episodes 2 and/or 7 months after the death. CONCLUSIONS:
Depressive episodes are common after the death of a spouse. Clinicians
should maintain a high index of suspicion for the possibility of
depression, particularly in young widows and widowers who have a past
history of depression or who experience a full depressive syndrome soon
after the loss.
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