Complicated Grief and Bereavement-Related Depression as Distinct Disorders: Preliminary Empirical Validation in Elderly Bereaved Spouses

Objective: This study sought to determine whether a set of symptoms interpreted as corn-plicated grief could be identified and distinguished from bereavement-related depression and whether the presence of complicated grief would predict enduring functional impairments. Method: Data were derived from a study group of 82 recently widowed elderly individuals recruited for an investigation ofphysiological changes in bereaved persons. Baseline data were collected 3-6 months after the deaths of the subjects ’ spouses, and follow-up data were col-lected from 56 of the subjects I 8 months after the baseline assessments. Candidate items for assessing complicated griefcame from a variety ofscales used to evaluate emotional function-ing (e.g., the Hamilton Depression Rating Scale, the BriefSymptom Inventory). The outcome variables measured were global functioning, medical illness burden, sleep, mood, self-esteem, and anxiety. Results: A principal-components analysis conducted on intake data (N=82) re-vealed a complicated grieffactor and a bereavement-depression factor. Seven symptoms con-stituted complicated grief: searching, yearning, preoccupation with thoughts of the deceased, crying, disbelief regarding the death, feeling stunned by the death, and lack of acceptance of the death. Baseline complicated griefscores were significantly associated with impairments i