In samples where mortality risk is reported in surviving spouses, no difference between expected deaths and unexpected deaths has been reported.68 However, the anticipatory bereavement period may provide opportunity for potential preventative strategies targeting health outcome. Indeed, it is worth noting that in one matched retrospective cohort study69 that compared mortality risk among 30 838 couples where the deceased used hospice care and an equal number of couples where the deceased did not, analysis of spousal mortality revealed that bereaved Inhibitors,research,lifescience,medical spouses whose deceased

partners had used hospice services, compared with “control bereaved” subjects who did not, were less likely to die themselves in the first 18 months of bereavement, with an adjusted odds ratio of 0.92 for widows and 0.95 for widowers. This study highlights the possible protective influence of social support during the anticipatory bereavement period on spousal outcome. In this study, hospice care was described as including nursing services, Inhibitors,research,lifescience,medical physician visits, homemaker assistance, social Inhibitors,research,lifescience,medical assistance, and bereavement counseling. The focus at the time of bereavement is naturally directed to the deceased person; the health and welfare of bereaved survivors is of concern to both surviving family members

and their health care practitioners. Further research is warranted, building on the body of evidence to date, to continue to prospectively evaluate physiological correlates in bereavement and also

to test preventive interventions targeted at reducing health risk during this universal and inevitable life stressor.
Well, while I’m here I’ll do the work—and Inhibitors,research,lifescience,medical what’s the work? To ease the pain of living.” Allen Inhibitors,research,lifescience,medical Ginsberg The thoughtful articles in this issue highlight many of the scientific and diagnostic questions surrounding the concept of “complicated grief.” Along with the contentious issue of the “bereavement exclusion” in the still-developing DSM-5, complicated grief (CG) raises important questions regarding the boundaries between “normal” and “abnormal” grief, between grief and post-traumatic see more stress disorder (PTSD), and between CG and major depressive disorder (MDD). And Resminostat yet, important though these “boundary” issues are, I sometimes wonder if we lose sight of the underlying philosophical and ethical foundation of why we have a diagnostic classification in the first place. Perhaps the obvious answer may be derived from the Greek etymology of the term “diagnosis”; literally, the word means “knowing the difference between.” We create categories in psychiatry in order to help us tell the difference between conditions we presume exist not only in our patients but, in some sense, in “Nature.” Here we recognize the implicit Platonic underpinnings of medical diagnosis: we aim, as Plato put it in the Phaeadrus, to “carve Nature at its joints.