Differentiating symptoms of complicated grief and depression among psychiatric outpatients.
OBJECTIVE
This study examined whether dimensions of complicated grief (CG) could be distinguished from dimensions of depression and whether these dimensions were differentially affected by group psychotherapy for CG.


METHODS
A total of 398 psychiatric outpatients who had experienced one or more significant death losses provided ratings on standard measures of grief and depression. Factor analysis of the 56 items from these measures was used to explore the possibility that grief and depression symptoms would form separate dimensions of distress. Subsamples of the patients also participated in 1 of 2 forms of short-term group therapy for CG. Repeated-measures analysis of variance and calculation of effect sizes were performed to examine changes in the dimensions following treatment.


RESULTS
The grief items formed 3 distinct clusters representing different dimensions of CG. None of the depression items loaded highly on these grief dimensions. The depression items formed 2 distinct clusters. Two of the grief dimensions demonstrated the most improvement following group therapy that addressed CG. There was also evidence for differential effectiveness of the 2 forms of group therapy.


CONCLUSIONS
When assessing psychiatric patients who have death losses, clinicians should consider different types of grief reactions. Different types of grief reactions may be responsive to different treatments. In the absence of depressive symptoms, clinicians should not assume the absence of CG.
Ogrodniczuk
John S
JS
Department of Psychiatry, 2250 Webrook Mall, University of British Columbia, Vancouver, BC V6T 1W6. ogrodnic@interchange.ubc.ca
Piper
William E
WE
Joyce
Anthony S
AS
Weideman
Rene
R
McCallum
Mary
M
Azim
Hassan F
HF
Rosie
John Sincerely
JS
D000328:Adult; D000553:Ambulatory Care; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D011897:Random Allocation; D011795:Surveys and Questionnaires