PSYCHOLOGICAL CHANGES IN PARENTS 8 MONTHS AFTER THE LOSS OF AN INFANTFROM STILLBIRTH, NEONATAL DEATH, OR SUDDEN-INFANT-DEATH-SYNDROME - A LONGITUDINAL-STUDY

Objective. We proposed to measure part of the natural history of grief by determining the changes in the psychological symptoms experienced by bereaved parents over the 8 months after the loss of an infant from sudden infant death syndrome (SIDS), neonatal death (NND), or stillbi rth (SB). Parents were interviewed twice, at 2 and 8 months after the loss. Methodology. A total of 220 bereaved families (45 SIDS, 93 NND, and 82 SB) were compared with 226 control families who had a live born child. Comparison was based on responses to a standardized measure of anxiety and depression (Delusions-Symptoms-States Inventory). Results . For separate cross-sectional comparison at both 2 and 8 months, sign ificant differences were noted in the frequency of maternal symptoms o f anxiety and depression between bereaved and control groups (P < .001 ). Such differences were present for paternal anxiety and depression a t 2 months, but not 8 months. A second series of analysis examined lon gitudinal changes in symptom frequency between 2 and 8 months for each bereaved group. For mothers, the changes were significant for anxiety and depression: SIDS and NND (P < .001), SB (P < .01). For fathers, t he changes for anxiety and depression in SIDS were P < .01; NND, P < . 05 for anxiety and P < .01 per depression; changes were not significan t for SB. At 2 months, relative risks for symptoms of maternal anxiety were significant for all three bereaved groups: SIDS, 22.4; NND, 5.4; and SB, 5.1. Comparable significant figures at 8 months were: SIDS, 5 .5; NND, 3.9; and SB, 3.0, respectively. For depression the results fo r 2 months were: SIDS, 8.6; NND, 5.9; and SE, 6.7 (all significant) wh ile at 8 months the results were: SIDS, 5.1; NND, 3.8; and SB, 2.4 (SB group not significant). For fathers the relevant risks were generally lower. At 2 months, anxiety levels were higher than controls in all t hree groups, and for depression in the SIDS and SB groups. At 8 months , significant results persisted only in the SB group. Conclusion. Thes e data indicate that bereaved parents have a marked reduction in the s ymptoms of mental illness over the first 8 months after the loss. Alth ough the changes over time are significant for both mothers and