Treatment of complicated grief - A randomized controlled trial
Treatment of complicated grief - A randomized controlled trial
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DOI：
10.1001/jama.293.21.2601
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发表时间：
2005-06-01
影响因子：
120.7
通讯作者：
Reynolds, CF
中科院分区：
文献类型：
--
作者：
Shear, K;Frank, E;Reynolds, CF
背景复杂性悲伤是一种与严重的负面健康后果相关的衰弱性疾病，但现有的治疗方法效果令人失望。目的比较一种新的方法--复杂性悲伤治疗与标准心理治疗的疗效设计双细胞、前瞻性、随机对照临床试验，根据所爱的人的死亡方式和治疗地点分层。设置一个大学为基础的精神病研究诊所以及一个卫星诊所在一个低-研究对象为2001年4月至2004年4月期间，通过专业推荐、自我推荐干预措施参与者被随机分配接受人际心理治疗（n=46）或复杂悲伤治疗（n=49）;两种药物均在16个疗程中给药，平均间隔为19周。主要结果测量治疗反应，定义为独立评估者评定的临床总体改善评分为1或2分，或作为时间到20分或更好的改善，在自我报告的复杂的悲伤Inventory of Complicated Grief.Results两种治疗方法产生的复杂的悲伤症状的改善。复杂悲伤治疗的反应率（51%）高于人际心理治疗（28%; P = 0.02），复杂悲伤治疗的反应时间更快（P = 0.02）。结论复杂性悲伤治疗是一种较人际心理治疗更好的治疗方法，有效率更高，见效更快。
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 2004.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 participant.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.