pensive elderly lady

Among the 40 million Americans older than 65 years, 40 percent of women and 13 percent of men are widowed. Bereavement rates for other close relationships are also high. About 9 percent of bereaved older women experience complicated grief (CG), a debilitating condition that if left untreated may lead to various negative health outcomes, including increased suicidality. Typical symptoms of complicated grief include:

  • prolonged acute grief with intense yearning, longing, and sorrow;
  • frequent thoughts and memories of the deceased; and
  • difficulty comprehending the painful reality and imagining a future with purpose and meaning.

Katherine Shear, the Marion E. Kenworthy Professor of Psychiatry in Social Work at the Columbia School of Social Work and a world expert on this form of grief, recently completed the first full-scale randomized clinical trial studying complicated grief in the elderly. Her goal was to compare a targeted complicated grief treatment (CGT) to a grief-focused interpersonal psychotherapy (IPT), a well-known evidence-based therapy for depression.

Dr. Shear’s specially designed treatment method includes a technique in which patients repeatedly visualize the moment they learned their loved one died and tell the story of what happened after that, an exercise that helps them grapple with the painful reality.

As reported September 24, 2014, online in JAMA Psychiatry, Dr. Shear’s research group recruited 151 adults with an average age of 66, mostly women, from the New York metropolitan area. The median time since the loss of a loved one was about three years. About half of the group received 16 weekly sessions of CGT and the other half the same number of sessions of IPT. The trials took place over four-and-a-half years between 2008 and 2013.

Results showed that although both treatments produced improvement in complicated grief symptoms, there was a big difference in the rates of response: 70 for CGT compared to 32 percent for IPT.

“Our results strongly support the need for physicians and other health care providers to distinguish complicated grief from depression,” Dr. Shear said. “Given the growing elderly population, the high prevalence of bereavement in aging individuals, and the marked physical and psychological impact of CG, clinicians need to know how to treat CG in older adults.”

Img: "Old lady," by Ulrica Törning (CC BY-SA 2.0).

Related Links:

Study Featured on CBS New York, 24 Sept 2014:

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