Psychiatry: unresolved grief. Clinical considerations.

Unresolved grief refers either to the absence or to the prolongation of normal grief. It is identified by (1) painful response to recall of the deceased, (2) realization of not having accepted the loss or of not being able to grieve, and (3) unaccountable depression, emergence of medical symptoms on the anniversary of the loss, or both. Three clinical syndromes can be defined in relation to the stage at which the grief process has been arrested. Treatment involves encouraging patients to talk about the deceased and guiding them through a normal grief reaction. Psychiatric evaluation should be considered when suicidal ideation is present.