NEW YORK, May 07 (Reuters) -- The death of a spouse is one of the most stressful life events, and bereavement is a known risk factor for health problems. But a new study shows that the risk of long-term mental and physical problems is even greater among those who suffer "traumatic grief," a psychiatric condition of profound emotional trauma and "separation distress" triggered by a spouse's death. This type of grief may increase the risk for cancer and heart disease, according to researchers at Yale and the University of Pittsburgh.
"People with traumatic grief seem to have a particularly more difficult form of grieving that keeps them locked into the grief," says study co-author Pittsburgh associate professor of psychiatry Dr. M. Katherine Shear. "Everybody grieves and some get depressed. But depression seems more treatable and somewhat less persistent."
"Traumatic grief seems to be a type of grief that looks like post-traumatic stress syndrome," she adds.
The study included 150 people whose spouses had a life-threatening illness. The study participants were interviewed at the time of their spouse's hospital admission, at 6-weeks, and at 6-, 13-, and 25-month follow-ups. Traumatic grief among bereaved spouses was identified by looking for 19 symptoms, such as preoccupation with thoughts of the deceased, yearning and searching for the deceased, feeling disbelief and stunned by the death, avoidance of reminders of the deceased, auditory and visual hallucinations of the lost spouse, bitterness and guilt over the death.
Study participants diagnosed with traumatic grief at six months after the spouse's death were significantly more likely than others to develop heart trouble, high blood pressure, thoughts of suicide, and changes in eating habits at subsequent follow-up exams.
Moreover, the higher the bereaved person's grief score, the greater the likelihood of later physical and mental problems. For each increment of traumatic grief measured by the researchers, the bereaved person was 1.11 times more likely to develop high blood pressure at 13 months, 7.02 times more likely to change eating habits, and 1.15 times more likely to develop heart trouble than those whose grief scores was zero.
In addition, for every increment in traumatic grief, bereaved smokers were 16.7 times more likely to start smoking more or to take up the nicotine habit.
Compared to those whose traumatic grief score was low at the 6-month evaluation, bereaved people with high scores "had substantially higher rates of heart trouble and cancer, as well as more reports of headaches and the flu at an anniversary of the spouse's death" say the researchers.
The results of this study suggest it is symptoms of traumatic grief rather than the stress of bereavement, per se, "that puts people at risk for long-term mental and physical health impairments."
Shear also notes that she and her colleagues are currently developing psychotherapy methods targeted to people with traumatic grief, largely because "standard treatments for depression don't seem to have as good efficacy for this syndrome -- they don't really help it."
SOURCE: American Journal of Psychiatry (1997;154(5):616-623)
