Several previous studies had shown that symptoms of traumatic grief constituted a distinct form of bereavement-related emotional stress which was different from bereavement-related depression and anxiety. These studies had usually been undertaken in bereaved elders whose partners had died from illness.

Dr Paul Boelen, from Utrecht University, and colleagues investigated whether this distinction was also true in 103 patients seeking help for problems with grief after the death of a first-degree relative.

All patients had experienced the loss of a relative at least two months earlier, were over 18 years of age and were experiencing emotional problems with grief.

Of these patients, 25.2 per cent met the DSM-IV criteria for a depressive disorder, 2.9 per cent for an anxiety disorder and 9.7 per cent for both depression and anxiety disorder.

Traumatic grief was measured using the Inventory of Traumatic Grief, and depression and anxiety using the Symptom Checklist. Principal axis factoring was used to establish whether the three symptom clusters were distinct.

Factoring analysis showed symptoms of traumatic grief, depression and anxiety cluster together as three distinct entities.

Dr Boelen says, “The results indicate that the complications of bereavement may include symptoms of traumatic grief that constitute a clinical entity distinct from bereavement-related depression and anxiety. This contrasts with DSM-IV, in which traumatic grief is not a separate clinical entity.”

And he adds that this suggests different treatment methods may be required for the various syndromes that develop in people who fail to recover from bereavement.

Reference: Boelen et al, American Journal of Psychiatry 2003;160:1339-1341

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