Article

Complicated grief after perinatal loss

Department of Psychosomatic Medicine, University of Leipzig, Germany.
Dialogues in clinical neuroscience 06/2012; 14(2):187-94.
Source: PubMed

ABSTRACT The loss of an infant through stillbirth, miscarriage, or neonatal death is recognized as a traumatic life event. Predictors of development of complicated grief after prenatal loss include lack of social support, pre-existing relationship difficulties, or absence of surviving children, as well as ambivalent attitudes or heightened perception of the reality of the pregnancy. Risk of complicated grief was found to be especially high after termination of a pregnancy due to fetal abnormality. Studies have revealed that men and women show different patterns of grief, potentially exacerbating decline in a relationship. Although it is clear that prenatal loss has a large psychological impact, it is concluded that there is a substantial lack of randomized controlled studies in this field of research.

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    • "Parents may experience the world as no longer feeling safe and predictable, and they may realize they are vulnerable in ways they did not previously recognize [4]. Although grief itself is a normal human reaction, some individuals suffer from complicated grieving experiences, and mental health disorders can be comorbid with normal grief [5] [6]. Most parents weather the storm of perinatal loss, but some families struggle to recover from this event [7] [8] [9]. "
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    ABSTRACT: Objective Perinatal loss (stillbirth after 20 weeks gestational age or infant death in the first month) impacts 1–2 infants per hundred live births in the United States and can be a devastating experience for parents. We assessed prevalence of anxiety disorders and obsessive compulsive disorder (OCD) among bereaved and live-birth mothers. Methods We collaborated with the Michigan Department of Public Health to survey Michigan mothers with perinatal death or live birth. We measured symptoms of generalized anxiety disorder, social phobia, panic disorder, and OCD using validated written self-report screens and collected data on maternal demographics, psychiatric history, social support, andintimate partner violence. Results 609/1400 mothers (44%) participated, returning surveys nine months post-delivery. 232 mothers had live birth and 377 had perinatal loss. In unadjusted analyses, bereaved mothers had higher odds of all four disorders. In logistic regression adjusted for covariates, bereaved mothers still had higher odds of moderate-severe generalized anxiety disorder (OR: 2.39, CI: 1.10-5.18, p = 0.028) and social phobia (OR: 2.32, CI: 1.52-3.54, p < 0.0005 but not panic disorder or OCD. Conclusion Bereaved mothers struggle with clinically-significant anxiety disorders in the first year after perinatal loss; improved identification and treatment are essential to improve mental health for this vulnerable population.
    General Hospital Psychiatry 09/2014; 36(6). DOI:10.1016/j.genhosppsych.2014.09.008 · 2.90 Impact Factor
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    • "The loss of a child is often thought as unjust and unexpected, no matter if the death is natural or traumatic, and the bereaved may need to reconstruct their identity, lifestyle, and world outlook after such a loss (Hibberd et al., 2010). In a population-based sample, bereaved individuals who had lost a child showed the highest prevalence of PGD (Keesee et al., 2008; Kersting and Wagner, 2012). Consistent with the research, our study showed that the loss of a child was also the most noticeable predictor of prolonged grief (Table 4). "
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    ABSTRACT: Few epidemiological studies have investigated prolonged grief disorder (PGD) in the general population of Asian countries, including China. The aim of this study was to explore the rates and risks of PGD, and the association between PGD, post-traumatic stress disorder (PTSD), depression and anxiety in bereaved Chinese adults. The PG-13, PTSD Checklist-Civilian Version (PCL-C), Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) were administered to 445 subjects. Prevalence within the general population of China was 1.8% (i.e., 8/445). Among the eight subjects who met the PGD diagnosis, 75%, 87.5% and 75% scored above the cut-off point on the PCL-C, SDS and SAS, respectively, although a portion remained free from comorbidity. ANOVA, correlation analysis and stepwise multiple regression analysis demonstrated that kinship to deceased, age of the deceased, religion belief and cause of death were predictive of prolonged grief. A small proportion of bereaved persons may exhibit PGD. There is a substantial but far from complete overlap between PGD and the other three diagnoses. Bereaved parents and the widowed have high risk of PGD. These findings highlight the need for prevention, diagnosis and treatment for PGD patients.
    Psychiatry Research 05/2014; 219(2). DOI:10.1016/j.psychres.2014.05.022 · 2.68 Impact Factor
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    • "The circumstances surrounding the loss on grief and depression for parents can aggravate or ameliorate the loss experience (Meij et al., 2008). For example, the loss of a stillborn infant is a time that can never be relived (Radestad & Christoffersen, 2008) yet the previously common practice of removing a baby quickly after stillbirth has only recently been updated (Kersting & Wagner, 2012). The need for support during a major life event to prevent psychological difficulty is considered to be a key factor in helping people readjust (Agostini et al., 2011; Hess, Weinland, & Beebe, 2010). "
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    ABSTRACT: This article presents secondary analysis of data from parents who, 50 to 70 years ago, birthed stillborn babies or babies with lethal anomalies and from adult children born after these losses. The stories reflect a time in history when parents were "protected" from seeing or holding their babies and mothers were unable to attend the funeral. There was no understanding by society or caregivers for parents' need to process the loss or resources to build memories. They provide a strong argument for health care providers to offer such resources to parents today and offer grief support.
    Journal of Family Nursing 07/2013; 19(3). DOI:10.1177/1074840713495972 · 1.57 Impact Factor
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