Bereavement and common mental disorders in middle-aged adults: Results from the Brazilian longitudinal study of adult health (ELSA-Brasil)

Abstract

Background: Although bereavement is accompanied with depression and anxiety symptoms, it is usually not associated with increased rates of mental disorders in North American and European samples. Data from low- and middle income countries are, however, scarce. We therefore explored the prevalence of mental disorders after bereavement in Brazil. Methods: The Clinical Interview Schedule Revised (CIS-R) was used for psychiatric assessment of 15,105 participants from the Brazilian Health Longitudinal Study (ELSA-Brasil). We asked whether the participant suffered loss of a first degree relative/spouse within 6 and 12 months prior to the interview. Results: The prevalence within 6 and 12 months after bereavement for major depressive disorder (MDD, 4.3% for 6 and 12 months) and anxiety disorders (17.4% and 15.9%, respectively) did not differ compared to non bereaved participants, except for panic disorder. Sociodemo;,Yraphic and clinical data were also similar. Conversely, we found increased 12 month prevalence of bereaved related (vs. non related) mixed anxiety and depressive disorder (15.7% vs. 12.5%, respectively) and common mental disorder (30.7% vs. 262%); diagnoses that are solely based on the number and severity of depression and anxiety symptoms. Limitations: Although this was a cross-sectional study, the sample size was large. Conclusions: Bereavement was associated with greater psychopathological burden but not with increased prevalence of MDD and anxiety disorder diagnoses, therefore highlighting the need of carefully monitoring subjects whom recently experienced bereavement. Our Findings also support and provide a ""cultural validator"" for excluding bereavement as an exclusionary criterion for MOD diagnosis.