Treatment of complicated grief: a randomized controlled trial

JAMA. 2005 Jun 1;293(21):2601-8. doi: 10.1001/jama.293.21.2601.


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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adaptation, Psychological*
  • Adjustment Disorders / etiology*
  • Adjustment Disorders / therapy*
  • Adult
  • Affective Symptoms / etiology*
  • Affective Symptoms / therapy*
  • Aged
  • Aged, 80 and over
  • Cognitive Behavioral Therapy*
  • Depressive Disorder, Major / etiology
  • Depressive Disorder, Major / therapy
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Grief*
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / etiology
  • Mood Disorders / therapy
  • Prospective Studies
  • Psychotherapy, Brief*
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / therapy