Suicidal Ideation in Elderly Bereaved: The Role of Complicated Grief

Abstract

This study examined whether symptoms of complicated grief at baseline predicted suicidal ideation during a depressive episode in elderly bereaved individuals. Over a 17‐month period, serial ratings of suicidal ideation, hopelessness, and symptoms of depression, anxiety, and complicated grief were obtained from 130 elderly participants who had lost their spouses within the past 2 years. Groups of active and passive suicidal ideators, as well as nonideator controls, were compared via analysis of variance (ANOVA) with respect to levels of complicated grief, depression, and anxiety. Elderly bereaved with both active and passive suicidal ideation were found to have higher symptomatic levels of depression, hopelessness, complicated grief, and anxiety, as well as lower levels of perceived social support, than nonideators at study entry. Fifty‐seven percent of the patients with high complicated grief scores were found to be ideators during the follow‐up versus 24% of the patients with low complicated grief scores. Patients with any suicidal ideation had higher symptom levels of depression, anxiety, and complicated grief when they were ideators as compared with periods when they denied ideation. Fifteen out of the 39 ideators had recurrent depressive episodes versus 5 of the 91 nonideators. Patients with a history of suicide attempts were more likely to be ideators after loss than other bereaved. Thus, the condition of having high levels of complicated grief symptoms and depressive symptoms appears to make bereaved individuals vulnerable to suicidal ideation. Detection of high levels of complicated grief could help clinicians identify patients who may be at heightened risk for suicide.

Complicated grief and its relationship with anxiety, depression, and suicidal ideation in older adults in the context of the COVID-19 pandemic in Peru: a cross-sectional analysis

“…CG was identified as a significant risk factor for depression in the population studied. Additionally, Szanto et al (2020) in the United States found that CG severity was a significant predictor of suicidal ideation in elderly bereaved individuals [ 19 ]. Finally, Dominguez-Lopez et al (2021) reported that grief in Mexican older adults seeking psychological support during the COVID-19 pandemic was significantly associated with higher anxiety symptoms than in younger adults [ 20 ].…”

“…Complicated grief may lead to negative self-evaluations and feelings of guilt, dysregulation of the hypothalamic-pituitary-adrenal axis that regulates the body’s stress response, and difficulty regulating emotions, all of which may contribute to the development of anxiety [ 22 – 24 ]. The emotional pain, sense of hopelessness and despair associated with CG, as well as the loss of meaning and purpose, social isolation, and withdrawal may also increase the risk of suicidal ideation [ 19 ].…”

Complicated grief and its relationship with anxiety, depression, and risk suicide in older adults in the context of the COVID-19 pandemic in Peru: a cross-sectional analysis

“…Complicated grief may lead to negative self-evaluations and feelings of guilt, dysregulation of the hypothalamic-pituitary-adrenal axis that regulates the body's stress response, and di culty regulating emotions, all of which may contribute to the development of anxiety (16-18). The emotional pain, sense of hopelessness and despair associated with CG, as well as the loss of meaning and purpose, social isolation, and withdrawal, may also increase the risk of suicidal ideation (13).…”

Eye Movement Desensitisation and Reprocessing (EMDR) therapy for prolonged grief: theory, research, and practice

“…Although there is no direct research on the duration of PGD, it is commonly understood this disorder can last years and decades without significant improvement in symptoms (2). PGD has been associated with increased rates of suicidality, mental disorder and sleep disturbance, poor health behaviors, and work and social impairment (3)(4)(5)(6)(7)(8). Due to the functional impact, increasing rates, and challenges associated with having a prolonged grief response, identifying individuals at risk, and those who need evidenced based treatments is of great importance.…”