The latest update to the Diagnostic and Statistical Manual of Mental Disorders, the codebook used by mental health professionals, includes a new officially recognised condition: prolonged grief disorder. People with prolonged grief are considered to have intense feelings and preoccupied thoughts that distress them or impede their daily functioning beyond the normal grieving process.
The DSM was created by the American Psychiatry Association and is often called the bible of psychiatry. It’s not only a guidebook for clinicians, though, since insurance providers typically rely on the DSM to approve coverage of treatments for these various disorders. So validation in the DSM carries important financial weight as well.
According to the APA, people with prolonged grief may experience “intense longings for the deceased or preoccupation with thoughts of the deceased, or in children and adolescents, with the circumstances around the death.” These reactions to grief would further affect them most of the day, nearly every day, for at least a month. In children, the DSM criteria notes, the condition can be diagnosed six months after the loss, while it can be diagnosed in adults after a year. And the APA also reminds clinicians that people’s symptoms shouldn’t be better explained by other conditions.
Since at least 2010, some psychiatrists have been trying to add prolonged grief disorder to the DSM, which routinely goes through new editions and smaller revisions. Advocates have argued that people with prolonged grief are distinctly identifiable from those afflicted by typical grief, as well as conditions possibly related to loss, such as post-traumatic stress disorder and depression. But a fair share of critics have opposed its addition, including former members of the DSM task force, who have argued that the diagnosis would pathologize normal behaviour. It’s a criticism that’s been lodged against other recently added conditions to the DSM, such as gaming addiction.
Changes to the DSM are approved through a collaborative process, though, and by the fall of 2021, prolonged grief disorder was cleared for inclusion. This week, the American Psychiatric Association formally released the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), with prolonged grief disorder the latest and only new condition to be added onto it.
“Including prolonged grief disorder in the DSM-5-TR will mean that mental health clinicians and patients and families alike share an understanding of what normal grief looks like and what might indicate a long-term problem,” said Saul Levin, CEO and medical director of the APA, in September 2021 when the condition was first announced for inclusion. “Especially now, sharing information and increasing awareness about prolonged grief disorder is essential.”
Editor’s Note: Release dates within this article are based in the U.S., but will be updated with local Australian dates as soon as we know more.