Treatment of complicated grief: a randomized controlled trial.
BACKGROUND
Complicated grief is a debilitating disorder associated with important negative health consequences, but the results of existing treatments for it have been disappointing.


OBJECTIVE
To compare the efficacy of a novel approach, complicated grief treatment, with a standard psychotherapy (interpersonal psychotherapy).


METHODS
Two-cell, prospective, randomized controlled clinical trial, stratified by manner of death of loved one and treatment site.


METHODS
A university-based psychiatric research clinic as well as a satellite clinic in a low-income African American community between April 2001 and April 2004.


METHODS
A total of 83 women and 12 men aged 18 to 85 years recruited through professional referral, self-referral, and media announcements who met criteria for complicated grief.


METHODS
Participants were randomly assigned to receive interpersonal psychotherapy (n = 46) or complicated grief treatment (n = 49); both were administered in 16 sessions during an average interval of 19 weeks per participant.


METHODS
Treatment response, defined either as independent evaluator-rated Clinical Global Improvement score of 1 or 2 or as time to a 20-point or better improvement in the self-reported Inventory of Complicated Grief.


RESULTS
Both treatments produced improvement in complicated grief symptoms. The response rate was greater for complicated grief treatment (51%) than for interpersonal psychotherapy (28%; P = .02) and time to response was faster for complicated grief treatment (P = .02). The number needed to treat was 4.3.


CONCLUSIONS
Complicated grief treatment is an improved treatment over interpersonal psychotherapy, showing higher response rates and faster time to response.
Shear
Katherine
K
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pa 15213, USA. shearmk@upmc.edu
Frank
Ellen
E
Houck
Patricia R
PR
Reynolds
Charles F
CF
D000223:Adaptation, Psychological; D000275:Adjustment Disorders / Q000209:etiology* / Q000628:therapy*; D000328:Adult; D000342:Affective Symptoms / Q000209:etiology* / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000209:etiology / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D011614:Psychotherapy, Brief; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000628:therapy