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Shear K, Frank E, Houck PR, Reynolds CF. Treatment of Complicated Grief: A Randomized Controlled Trial. JAMA. 2005;293(21):2601–2608. doi:10.1001/jama.293.21.2601
Author Affiliations: Department of Psychiatry,
University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Context 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).
Design Two-cell, prospective, randomized controlled clinical trial, stratified
by manner of death of loved one and treatment site.
Setting A university-based psychiatric research clinic as well as a satellite
clinic in a low-income African American community between April 2001 and April
Participants 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.
Interventions 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
Main Outcome Measure 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.
Conclusion Complicated grief treatment is an improved treatment over interpersonal
psychotherapy, showing higher response rates and faster time to response.
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