de Groot Marieke, de Keijser Jos, Neeleman Jan, Kerkhof Ad, Nolen Willem, Burger Huibert
Department of Social Psychiatry, University of Groningen, PO Box 30.001, 9700 RB Groningen, Netherlands.
BMJ. 2007 May 12;334(7601):994. doi: 10.1136/bmj.39161.457431.55. Epub 2007 Apr 20.
To examine the effectiveness of a family based grief counselling programme to prevent complicated grief among first degree relatives and spouses of someone who had committed suicide.
Cluster randomised controlled trial with follow-up at 13 months after the suicide.
General practices in the Netherlands.
122 first degree relatives and spouses of 70 people who committed suicide; 39 families (68 participants) were allocated to intervention, 31 families (54 participants) to control.
A family based, cognitive behaviour counselling programme of four sessions with a trained psychiatric nurse counsellor between three to six months after the suicide. Control participants received usual care.
Self report complicated grief. Secondary outcomes were the presence of maladaptive grief reactions, depression, suicidal ideation, and perceptions of being to blame for the suicide.
The intervention was not associated with a reduction in complicated grief (mean difference -0.61, 95% confidence interval -6.05 to 4.83; P=0.82). Secondary outcomes were not affected either. When adjusted for baseline inequalities, the intervention reduced the risk of perceptions of being to blame (odds ratio 0.18, 0.05 to 0.67; P=0.01) and maladaptive grief reactions (0.39, 0.15 to 1.01; P=0.06).
A cognitive behaviour grief counselling programme for families bereaved by suicide did not reduce the risk of complicated grief or suicidal ideation or the level of depression. The programme may help to prevent maladaptive grief reactions and perceptions of blame among first degree relatives and spouses.
Current Controlled Trials ISRCTN66473618.
探讨一项基于家庭的悲伤辅导计划对预防自杀者一级亲属和配偶出现复杂性悲伤的效果。
整群随机对照试验，在自杀事件发生13个月后进行随访。
荷兰的普通诊所。
70名自杀者的122名一级亲属和配偶；39个家庭（68名参与者）被分配到干预组，31个家庭（54名参与者）被分配到对照组。
在自杀事件发生后的三至六个月内，由一名经过培训的精神科护士顾问开展一项为期四节的基于家庭的认知行为辅导计划。对照组参与者接受常规护理。
自我报告的复杂性悲伤。次要观察指标包括适应不良的悲伤反应、抑郁、自杀意念以及对自杀负有责任的认知。
该干预措施与复杂性悲伤的减少无关（平均差异-0.61，95%置信区间-6.05至4.83；P=0.82）。次要观察指标也未受影响。在对基线不平等进行调整后，该干预措施降低了认为自己负有责任的风险（比值比0.18，0.05至0.67；P=0.01）以及适应不良的悲伤反应（0.39，0.15至1.01；P=0.06）。
一项针对自杀丧亲家庭的认知行为悲伤辅导计划并未降低复杂性悲伤、自杀意念或抑郁水平的风险。该计划可能有助于预防一级亲属和配偶出现适应不良的悲伤反应以及自责感。
Current Controlled Trials ISRCTN66473618 。
