Distinguishing symptoms of grief and depression in a cohort of advanced cancer patients.
Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer patients. Grief was measured using symptoms from the patient version of the Inventory of Complicated Grief-Revised (ICG-R) and symptoms of depression were assessed using the Structured Clinical Interview for DSM-IV (SCID). A factor analysis revealed that symptoms of patient grief formed a coherent factor that was distinct from a depression factor. Patient grief "caseness" (defined as being in the top 10% of the distribution of grief scores), but not major depressive disorder, was uniquely associated with the wish to die (odds ratio [OR] 10.13 [0.1.08-95.06]). Both depression and grief were significantly associated with mental health service use (OR 16.07 [1.68, 153.77] vs. 4.82; CI = [1.09, 21.41]) and negative religious coping (OR 1.36 [1.06, 1.73] vs. 1.25 [1.05, 1.49]); neither was associated with terminal illness acknowledgement.
Harvard Medical School Center for Palliative Care and Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. JJacobsen@partners.org
Juliet C
JC
Jacobsen
Center for Psycho-oncology and Palliative Care Research, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
Baohui
B
Zhang
Harvard Medical School Center for Palliative Care, Dana Farber Cancer Institute, Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Susan D
SD
Block
Center for Psycho-oncology and Palliative Care Research, Dana Farber Cancer Institute, Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Paul K
PK
Maciejewski
Harvard Medical School Center for Palliative Care, Dana Farber Cancer Institute, Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Holly G
HG
Prigerson
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D001293:Attitude to Death; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006117:Grief; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D016017:Odds Ratio; D012944:Social Support; D014481:United States