title: Impact of concurrent naturalistic pharmacotherapy on psychotherapy of complicated grief.
abstract: Complicated grief (CG) is a debilitating syndrome that can be reliably identified, but there is a paucity of research examining treatment of CG. A targeted psychotherapy for complicated grief (CGT) was recently shown to be efficacious [Shear, K., Frank, E., Houck, P.R., Reynolds, C.F., 3rd, 2005. Treatment of complicated grief: a randomized controlled trial. Journal of the American Medical Association 293, 2601-2608]. We provide a detailed examination of the association of naturalistic pharmacotherapy use with treatment response and study completion in the psychotherapy study. Patients on an antidepressant medication were more likely to complete a full course of CGT (91% vs. 58% completed), while antidepressant use had no effect on completion rates for the comparator, interpersonal psychotherapy (70% vs. 77%). Our naturalistic data underscore the need for prospective, randomized controlled studies of CG pharmacotherapy and psychotherapy alone and in combination.
authors.affiliation: Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital and Harvard Medical School, Boston MA 02114, USA. nsimon@partners.org
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
authors.forename: M Katherine
authors.initials: MK
authors.lastname: Shear
authors.forename: Andrea
authors.initials: A
authors.lastname: Fagiolini
authors.forename: Ellen
authors.initials: E
authors.lastname: Frank
authors.forename: Alyson
authors.initials: A
authors.lastname: Zalta
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Thompson
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.forename: Russell
authors.initials: R
authors.lastname: Silowash
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006117:Grief; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000379:methods*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012107:Research Design; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D040921:Stress Disorders, Traumatic / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D011619:Psychotropic Drugs