792 Conditions for Further Study
Functional Consequences of 
Persistent Complex Bereavement Disorder
Persistent complex bereavement di sorder is associated with deficits in work and social func-
tioning and with harmful health behaviors, such as increased tobacco and alcohol use. It is also
associated with marked increases in risks for serious medical conditions, including cardiac dis-
ease, hypertension, cancer, immunological deficiency, and reduced quality of life. 
Differential Diagnosis
Normal grief. Persistent complex bereavement diso rder is distinguished from normal
grief by the presence of severe grief reactions that persist at least 12 months (or 6 months in
children) after the death of the bereaved. It is only when severe levels of grief response per-
sist at least 12 months following the death an d interfere with the in dividual’s capacity to
function that persisten t complex bereavement disorder is diagnosed. 
Depressive disorders. Persistent complex bereavement disorder, major depressive dis-
order, and persistent depressive disorder (dysthymia) share sadness, crying, and suicidal
thinking. Whereas major depressi ve disorder and persistent de pressive disorder can share
depressed mood with persistent complex bereavement disorder, the latter is characterized
by a focus on the loss. 
Posttraumatic stress disorder. Individuals who experience bereavement as a result of trau-
matic death may develop both posttraumatic stre ss disorder (PTSD) and persistent complex
bereavement disorder. Both conditions ca n involve intrusive th oughts and avoidance.
Whereas intrusions in PTSD revolve around the traumatic event, intrusive memories in per-
sistent complex bereavement diso rder focus on thoughts about many aspects of the relation-
ship with the deceased, including positive asp ects of the relationship and distress over the