COMPLICATED GRIEF AND BEREAVEMENT-RELATED DEPRESSION AS DISTINCT DISORDERS - PRELIMINARY EMPIRICAL VALIDATION IN ELDERLY BEREAVED SPOUSES

Objective: This study sought to determine whether a set of symptoms in terpreted as complicated grief could be identified and distinguished f rom bereavement-related depression and whether the presence of complic ated grief would Predict enduring functional impairments. Method: Data were derived from a study group of 82 recently widowed elderly indivi duals recruited for an investigation of physiological changes in berea ved persons. Baseline data were collected 3-6 months after the deaths of the subjects' spouses, and follow-up data were collected from 56 of the subjects 18 months after the baseline assessments. Candidate item s for assessing complicated grief came from a variety of scales used t o evaluate emotional functioning (e.g., the Hamilton Depression Rating Scale, the Brief Symptom Inventory). The outcome variables measured w ere global functioning, medical illness burden, sleep, mood self-estee m, and anxiety. Results: A principal-components analysis conducted on intake data (N=82) revealed a complicated grief factor and a bereaveme nt-depression factor. Seven symptoms constituted complicated grief: se arching, yearning, preoccupation with thoughts of the deceased, crying , disbelief regarding the death, feeling stunned by the death, and lac k of acceptance of the death. Baseline complicated grief scores were s ignificantly associated with impairments in global functioning, mood, sleep, and self-esteem in the 56 subjects available for follow-up. Con clusions: The symptoms of complicated grief may be distinct from depre ssive symptoms and appear to be associated with enduring functional im pairments. The symptoms of complicated grief, therefore, appear to def ine a unique disorder deserving of specialized treatment.