Shear Katherine, Frank Ellen, Houck Patricia R, Reynolds Charles F
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pa 15213, USA.
JAMA. 2005 Jun 1;293(21):2601-8. doi: 10.1001/jama.293.21.2601.
Complicated grief is a debilitating disorder associated with important negative health consequences, but the results of existing treatments for it have been disappointing.
To compare the efficacy of a novel approach, complicated grief treatment, with a standard psychotherapy (interpersonal psychotherapy).
Two-cell, prospective, randomized controlled clinical trial, stratified by manner of death of loved one and treatment site.
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.
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.
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.
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.
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.
Complicated grief treatment is an improved treatment over interpersonal psychotherapy, showing higher response rates and faster time to response.
复杂性悲伤是一种使人衰弱的疾病，会带来严重的负面健康后果，但现有针对它的治疗效果一直令人失望。
比较一种新方法——复杂性悲伤治疗，与标准心理治疗（人际心理治疗）的疗效。
双组、前瞻性、随机对照临床试验，按所爱之人的死亡方式和治疗地点分层。
2001年4月至2004年4月期间，一家大学附属精神科研究诊所及一个低收入非裔美国社区的卫星诊所。
通过专业推荐、自我推荐和媒体公告招募的83名女性和12名男性，年龄在18至85岁之间，符合复杂性悲伤标准。
参与者被随机分配接受人际心理治疗（n = 46）或复杂性悲伤治疗（n = 49）；两者均在16次治疗中进行，每位参与者平均间隔19周。
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，或自我报告的复杂性悲伤量表改善20分或更多所需时间。
两种治疗均使复杂性悲伤症状有所改善。复杂性悲伤治疗的反应率（51%）高于人际心理治疗（28%；P = .02），且复杂性悲伤治疗的反应时间更快（P = .02）。治疗所需人数为4.3。
与人际心理治疗相比，复杂性悲伤治疗是一种更优的治疗方法，显示出更高的反应率和更快的反应时间。
