Clinical correlates of complicated grief among individuals with acute coronary syndromes

Abstract

ObjectiveThe study aimed at exploring bereavement and complicated grief (CG) symptoms among subjects without a history of coronary heart disease (CHD) at the time of a first acute coronary syndrome (ACS) and to evaluate the relationship of CG symptoms and ACS.MethodOverall, 149 subjects with ACS (namely, acute myocardial infarct with or without ST-segment elevation or unstable angina), with no previous history of CHD, admitted to three cardiac intensive care units were included and evaluated by the Structured Clinical Interview for Complicated Grief (SCI-CG), Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and the 36-item Short-Form Health Survey (MOS-SF-36).ResultsOf the total sample of 149 subjects with ACS, 118 (79.2%) met criteria for DSM-5 persistent complex bereavement disorder. Among these, subjects who lost a partner, child, or sibling were older (P=0.008), less likely to be working (P=0.032), and more likely to be suffering from hypertension (P=0.021), returned higher scores on the SCI-CG (P=0.001) and developed the index ACS more frequently between 12 and 48 months after the death than those who lost a parent or another relative (P≤0.0001). The occurrence of ACS 12–48 months (P=0.019) after the loss was positively correlated with SCI-CG scores. An inverse relationship with SCI-CG scores was observed for patients who experienced ACS more than 48 months after the loss (P=0.005). The SCI-CG scores significantly predicted lower scores on the “general health” domain of MOS-SF-36 (P=0.030), as well as lower scores on “emotional well-being” domain (P=0.010).ConclusionA great proportion of subjects with ACS report the loss of a loved one. Among these, the loss of a close relative and the severity of CG symptoms are associated with poorer health status. Our data corroborate previous data indicating a strong relationship between CG symptoms and severe cardiac problems.

Description of the Process of Grieving and Depression in Patient with Coronary Hearth Disease in the Intensive Room

“…Complicated grief where the patient may be confused about his identity, role socially, there are changes, responses and even depression that may be related with physiological changes such as increased heart rate or blood pressure, Increasing cortisol levels, sleep disorders and changes in the immune system body (Buckley et al, 2012;Shear, 2015). Complicated grief according to Pini, Gesi, Abelli, Cardini, Lari, Felice, ... & Borelli (2015) related to the incident coronary heart disease. Pini et al found in 149 subjects with the disease coronary heart disease, as many as 118 (79.2%) improve complicated grief.…”

A quasi‐experimental trial of narrative reconstruction for prolonged grief disorder: Symptomatic improvement and enhanced memory integration

“…Higher prevalence rates are associated with unnatural losses, with nearly half of such bereaved individuals experiencing PGD (Djelantik et al, 2020), and almost a quarter of parents who lost a child experiencing it (Kersting et al, 2011). PGDhas been shown to be distinct from depression and post‐traumatic stress disorder (PTSD) (Boelen & van den Bout, 2005; Cozza et al (2016); Jordan & Litz, 2014; Maciejewski et al, 2016; Prigerson et al, 2021) and to uniquely predict poor mental and physical health outcomes (Latham & Prigerson, 2011; Pini et al, 2015; Prigerson et al, 2008; Stroebe et al, 2013). Despite the distinction between disorders, results from some randomized clinical trials (RCTs) and a recent meta‐analysis have shown that PGD shares high comorbidity with major depressive disorder, PTSD, and/or depressive, anxiety, and post‐traumatic stress symptoms as secondary outcomes (Bryant et al, 2014; Eisma et al, 2015; Komischke‐Konnerup et al, 2021; Lenferink et al, 2017; Papa et al, 2013).…”

Poor physical and mental health predicts prolonged grief disorder: A prospective, population-based cohort study on caregivers of patients at the end of life

“… 23 – 26 However, only two previous studies have indicated an association between poor self-reported health in caregivers and PGD. 18 , 27 Both studies were cross-sectional and conducted after bereavement; one assessed health status before bereavement in a retrospective study design, whereas the other only examined health status after bereavement. Hence, a prospective study investigating whether caregivers’ health status during caregiving is a predictor of PGD could increase knowledge in this area and support prevention.…”

“…We aimed to describe the physical and mental health status in caregivers of patients at the end of life and to investigate whether health status may predict PGD. Based on previous research, 18,27 we hypothesised to find an association between poor physical and mental health in caregivers before bereavement and development of PGD after bereavement.…”