title: Prospective study of early bereavement on psychological and behavioural cardiac risk factors.
abstract: BACKGROUND
  Increasing evidence supports the role of emotional stress in the onset of cardiovascular disease. Although bereavement is a major emotional stress with both acute and more long-term features, the mechanism of its association with cardiovascular risk is not well understood, in particular because of limited studies of acute bereavement. The aim of the study was to identify psychological and behavioural changes in acute bereavement and potential modifiers of these changes.
  
  
  METHODS
  Bereaved (n= 62) and non-bereaved individuals (n= 50) were evaluated within 2 weeks and at 6 months following loss using the Centre for Epidemiologic Studies -- Depression, Spielberger State Anxiety and Anger, Social Support Questionnaire and changes in appetite, cigarette and alcohol consumption, cortisol and lipids.
  
  
  RESULTS
  Compared with non-bereaved, acutely bereaved had increased symptoms of depression (26.7 +/- 1.7 vs 5.9 +/- 0.7, P < 0.001), anxiety (47.4 +/- 2.0 vs 28.2 +/- 1.4, P < 0.001) and anger (median 16.0 vs 15.0, P < 0.001). Greater depressive symptoms were associated with being unprepared for the death, decreased sleep duration and younger age. Acutely, bereaved slept less than non-bereaved (5.8 +/- 0.2 vs 7.2 +/- 0.2 h, P < 0.001). Reduced sleep time was associated with increased anger and depression and decreased satisfaction with social support. Compared with the non-bereaved, the acutely bereaved had higher cortisol (median 306 vs 266, P= 0.003), reduced appetite (P < 0.001) and lower total cholesterol (median 4.9 vs 5.4, P= 0.006) and low-density lipoprotein (median 2.4 vs 2.9, P < 0.001).
  
  
  CONCLUSIONS
  These results offer insight into the psychological, behavioural and physical changes that may contribute to cardiovascular risk in bereavement.
authors.affiliation: Faculty of Nursing, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Buckley
authors.forename: R
authors.initials: R
authors.lastname: Bartrop
authors.forename: S
authors.initials: S
authors.lastname: McKinley
authors.forename: C
authors.initials: C
authors.lastname: Ward
authors.forename: M
authors.initials: M
authors.lastname: Bramwell
authors.forename: D
authors.initials: D
authors.lastname: Roche
authors.forename: A S
authors.initials: AS
authors.lastname: Mihailidou
authors.forename: M-C
authors.initials: MC
authors.lastname: Morel-Kopp
authors.forename: M
authors.initials: M
authors.lastname: Spinaze
authors.forename: B
authors.initials: B
authors.lastname: Hocking
authors.forename: K
authors.initials: K
authors.lastname: Goldston
authors.forename: C
authors.initials: C
authors.lastname: Tennant
authors.forename: G
authors.initials: G
authors.lastname: Tofler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000097:blood / Q000150:complications / Q000523:psychology; D013997:Time Factors