A critical analysis of debates on grief and depressive disorder in the age of the Diagnostic and Statistical Manual of Mental Disorders

https://doi.org/10.18294/sc.2019.2319

Published 24 October 2019 Open Access


Francisco Pizarro Obaid Psychologist. PhD in Sexuality, Reproduction and Perinatal Medicine. Associate Professor, Director of Postgraduate Studies, Faculty of Psychology, Universidad Diego Portales, Santiago, Chile. image/svg+xml , Rodrigo De La Fabián Albagli Psychologist. PhD in Fundamental Psychopathology. Associate Professor, Faculty of Psychology, Universidad Diego Portales, Santiago, Chile. image/svg+xml



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Keywords:

Mental Health, Major Depressive Disorder, Diagnostic and Statistical Manual of Mental Disorders

Abstract


Since the incorporation of the major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, and until its update in the DSM-IV-TR, the DSM classification system considered it necessary to include the criterion of “bereavement exclusion”, with the aim of differentiating normal sadness linked to a loss, from a mental disorder, such as the major depressive disorder. In its latest version (DSM-5), this exception was removed, giving rise to a controversy that continues to this day. The debate has set those who are in favor of maintaining this exclusion and extending it to other stressors against those who have intended to eradicate it. Our hypothesis is that these positions account for two qualitatively diverse clinical and epistemological matrices, linked to major transformations in health sciences and in psychiatry. We show that this debate involved a profound renewal of the meaning of psychiatric practice, a change in the function of diagnosis and in the way of conceiving the etiology of mental disorders, as well as a reformulation of the patient’s suffering status for the medical act.


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