Complicated grief in patients with unipolar depression

Department of Psychiatry, University of Muenster, Germany.
Journal of Affective Disorders (Impact Factor: 3.71). 04/2009; 118(1-3):201-4. DOI: 10.1016/j.jad.2009.01.033
Source: PubMed

ABSTRACT The loss of a close family member (e.g. child or spouse) has been shown to be one of the most stressful life-events increasing the risk of affective disorders. In the present study, we investigated for the first time the frequency of complicated grief in psychiatric inpatients with unipolar depression. Further, the study was aimed to identify characteristics predicting a complicated grief reaction in depressed patients.
In a sample of 73 DSM-IV diagnosed unipolar affective disordered inpatients grief, depression, anxiety and psychological stress reaction were assessed.
A high prevalence of loss and impairing complicated grief was found in this sample of unipolar depressed patients. Depressed patients with complicated grief were more severely depressed than depressed patients without complicated grief reactions. Higher traumatic stress and close family membership of the lost person were associated with higher severity of grief.
Comorbid complicated grief appears to contribute to greater severity and poorer functioning in unipolar depressed patients and should be specifically addressed in psychotherapeutic treatment.

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    • "It is important to note that the present sample is very different from most samples that explore prolonged grief. Other studies use predominantly older (or at least middle aged) participants who are recruited via hospices/hospitals; they have usually been involved in the care of the dying person therefore have a close relationship (Prigerson et al., 2002; Maercker et al., 2008; Kersting et al., 2009). Perhaps the prevalence rates previously published are not generalizable to the whole population. "
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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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    • "These studies estimate that 85–90% of bereaved individuals go through an uncomplicated and normal grieving process. A higher CG prevalence rate of 18.6% has been found in hospitalized patients with unipolar depression (Kersting et al., 2009), and a prevalence rate of 24.3% has been reported for bipolar patients (Simon et al., 2005). Epidemiological studies based on population-based surveys are rare. "
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    ABSTRACT: Complicated grief (CG) has been proposed as a distinct diagnostic category in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). However, few epidemiological studies to date have measured CG in the general population. Prevalence of CG, sociodemographic characteristics, and grief-related factors were examined in a representative population-based survey (N = 2520) through face-to-face contact. The sample included all bereaved subpopulations and all age groups from 14 to 95 years. The conditional prevalence of developing CG after major bereavement was 6.7%; the prevalence of CG in the general sample was 3.7%. Predictors of higher risk for developing CG were female gender, lower income (< €1250/month), older age (> 61 years), having lost a child or a spouse, or cancer as the cause of death. The sample of bereaved people was small, and some categories contained very few cases. Psychiatric comorbidities were not assessed in this study. The results indicate that CG is prevalent in the population, and risk factors were identified.
    Journal of Affective Disorders 06/2011; 131(1-3):339-43. DOI:10.1016/j.jad.2010.11.032 · 3.71 Impact Factor
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    • "range of time after bereavement , 10.4–16.4 years) (Kersting et al., 2009; Piper et al., 2001; Simon et al., 2005). Our study demonstrated that long-standing complicated grief is observed even among the general population. "
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    ABSTRACT: Few epidemiological studies have examined complicated grief in the general population, especially in Asian countries. Therefore, this study aimed to explore the prevalence and predictors of complicated grief among community dwelling individuals in Japan. A questionnaire survey regarding grief and related issues was conducted on community dwelling individuals aged 40-79 who were randomly sampled from census tracts. Complicated grief was assessed using the Brief Grief Questionnaire. Stepwise logistic regression analysis was conducted in order to identify predictors of complicated grief. Data from 969 responses (response rate, 39.9%) were subjected to analysis. The analysis revealed 22 (2.4%) respondents with complicated grief and 272 (22.7%) with subthreshold complicated grief. Respondents who were found to be at a higher risk for developing complicated grief had lost their spouse, lost a loved one unexpectedly, lost a loved one due to stroke or cardiac disease, lost a loved one at a hospice, care facility or at home, or spent time with the deceased everyday in the last week of life. Limitations of this study include the small sample size, the use of self-administered questionnaire, and the fact that the diagnoses of complicated grief were not based on robust diagnostic criteria. The point prevalence of complicated grief within 10years of bereavement was 2.4%. Complicated grief was maintained without significant decrease up to 10years after bereavement. When subthreshold complicated grief is included, the prevalence of complicated grief boosts up to a quarter of the sample, therefore, routine screening for complicated grief among the bereaved is desired. Clinicians should pay particular attention to the bereaved families with abovementioned risk factors in order to identify people at risk for future development of complicated grief.
    Journal of Affective Disorders 12/2010; 127(1-3):352-8. DOI:10.1016/j.jad.2010.06.008 · 3.71 Impact Factor
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