Grief as a diagnosis.

Grief is a natural and expected reaction to the loss of a loved one. However, it has for long been observed that grief following a death can also lead to disease. Neither of the two classification systems for mental disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD), has so far included a separate diagnosis for grief. Since the 1990s, systematic research efforts have been undertaken to attempt to establish consensus on a proposal for a separate diagnosis of grief. Frontrunners have included the American psychiatrists Mardi Horowitz and Katherine Shear, and not least the epidemiologist Holly Prigerson. European research communities have also been involved, for example in Switzerland, the Netherlands and Norway. Several proposals for a designation have been put forward, such as «traumatic grief», «complicated grief» and «prolonged grief disorder». The DSM-5, which is to be completed in 2013, now includes a specific proposal to include grief as a sub-category of adjustment disorders. The proposal in ICD-11, which will be published in 2015, is to categorise «prolonged grief disorder» as a separate diagnosis under stress-related disorders (1). Despite the different names, the criteria are mainly identical in the ICD11 and the DSM-5. In this article, I have chosen to use the designation «prolonged grief disorder».