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Complicated Grief Suffered by Senior Citizens May Be Treatable

Complicated grief is serious, debilitating mental health problem associated with functional impairment, increased suicide risk

depressed older womanSept. 24, 2014 – Recent research has been pointing to grief suffered by senior citizens as often having more serious consequences that for younger people. This “complicated grief” carries serious consequences and strikes about nine percent of bereaved older women. A recent test of a treatment for CG achieved a reduction in symptoms and less disease severity.

This treatment designed to help older individuals deal with complicated grief (CG) after the loss of a loved one appeared to be more effective than using a treatment that was designed to focus on depression, according to the online report today in JAMA Psychiatry.

About 9 percent of bereaved older women experience CG, a serious and debilitating mental health problem associated with functional impairment and increased suicide risk.

 

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The symptoms can include prolonged grief, frequent thoughts and memories of the deceased, and difficulty imagining a meaningful future. Interpersonal psychotherapy (IPT) is a well-known treatment for depression but observations suggest that CG symptoms do not respond well to IPT.

The study by M. Katherine Shear, M.D., of the Columbia University School of Social Work, New York, and colleagues was a randomized clinical trial that enrolled 151 patients (average age 66 years) from the New York metropolitan area from August 2008 to January 2013.

The authors developed a targeted CG treatment (CGT) based on an attachment therapy model. The aim was to resolve grief complications and facilitate natural mourning. The model focused on loss and restoration.

IPT discussed bereavement effects on mood, encouraged realistic assessment of the deceased, talked about the death and worked to enhance relationships and activities in the present.

The 151 individuals were divided into CGT (74) or IPT (77) to receive 16 sessions delivered about weekly. The average time since the loss of a spouse, partner, parent, child or another relative or friend was 3.2 years.

Both treatments helped improve CG symptoms. However, the response rate for CGT was more than twice that for IPT (CGT, 52 individuals - 70.5% - vs. IPT, 24 individuals - 32%).

There was a greater change in illness severity (22 individuals - 35.2% - in the CGT group vs. (41 individuals - 64.1%) in the IPT group who were still at least moderately ill. Symptom reduction per week also was greater in the CGT group.

“Complicated grief is an under recognized public health problem that likely affects millions of people in the United States, many of them elderly,” according to the researchers.

“Given a growing elderly population, increased rates of bereavement with age, and the distress and impairment associated with CG, effective treatment should have important public health outcomes.”

This study was supported by a grant from the National Institute of Mental Health.

 

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