title: Grief-related panic symptoms in Complicated Grief.
abstract: BACKGROUND
  Although Complicated Grief (CG) has been associated with comorbid Panic Disorder (PD), little is known about panic attacks in CG, and whether panic symptoms may be grief-related. The present study examines the presence and impact of grief-related panic symptoms in CG.
  
  
  METHODS
  Individuals with CG (n=146, 78% women, mean (SD) age=52.4(15.0)) were assessed for CG, DSM-IV diagnoses, work and social impairment, and with the Panic Disorder Severity Scale modified to assess symptoms "related to or triggered by reminders of your loss" and anticipatory worry.
  
  
  RESULTS
  Overall, 39.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and 32.2% reported some level of anticipatory worry about grief-related panic. Of interest, 17% met DSM criteria for PD. Among those without PD, 34.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and this was associated with higher CG symptom severity (t=-2.23, p<0.05), and functional impairment (t=-3.31, p<0.01). Among the full sample, controlling for CG symptom severity and current PD, the presence of at least one full or limited-symptom grief-related panic attack was independently associated with increased functional impairment (B(SE)=4.86(1.7), p<0.01).
  
  
  CONCLUSIONS
  Limitations include a lack of assessment of non-grief-related panic symptoms and examination of a sample of individuals seeking treatment for CG.
  
  
  CONCLUSIONS
  Grief-related panic symptoms may be prevalent among individuals with CG and independently contribute to distress and functional impairment.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States; Harvard Medical School, Boston, MA, United States. Electronic address: tebui@mgh.harvard.edu.
authors.forename: Eric
authors.initials: E
authors.lastname: Bui
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States.
authors.forename: Arielle
authors.initials: A
authors.lastname: Horenstein
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States.
authors.forename: Riva
authors.initials: R
authors.lastname: Shah
authors.affiliation: Columbia School of Social Work, New York, NY, United States.
authors.forename: Natalia A
authors.initials: NA
authors.lastname: Skritskaya
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Mauro
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States.
authors.forename: Yuanjia
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Biostatistics, Department of Psychiatry, Columbia University, New York, NY, United States.
authors.forename: Naihua
authors.initials: N
authors.lastname: Duan
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.affiliation: University of California, San Diego, CA, United States; VA San Diego Healthcare System, San Diego, CA, United States.
authors.forename: Sidney
authors.initials: S
authors.lastname: Zisook
authors.affiliation: Columbia School of Social Work, New York, NY, United States; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, United States.
authors.forename: M Katherine
authors.initials: MK
authors.lastname: Shear
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, One Bowdoin square, Boston, MA 02114, United States; Harvard Medical School, Boston, MA, United States.
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000523:psychology*; D012919:Social Behavior; D055815:Young Adult
keywords: Bereavement; Functional Impairment; Grief; Grief-Related Panic; Panic Disorder