School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St. CB 3550, Chapel Hill, NC 27599, USA.
School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St. CB 3550, Chapel Hill, NC 27599, USA.
J Subst Abuse Treat. 2019 Aug;103:43-57. doi: 10.1016/j.jsat.2019.05.012. Epub 2019 May 23.
Complicated grief is a prolonged, bereavement-specific disorder with significant psychological and physical consequences. Although complicated grief represents a risk to individuals with substance misuse, this relationship is poorly understood. Consequently, this systematic literature review examined empirical findings regarding the relationship between substance misuse and complicated grief. We searched 11 databases to identify pertinent quantitative studies published in English. Our search yielded 12 peer-reviewed journal articles (N = 1749) published between 1997 and 2017. Included studies evaluated the prevalence, assessment, etiology, correlates, risk factors, and treatment of complicated grief and substance misuse among individuals with one or both conditions. Our review found evidence of a positive relationship between complicated grief and substance misuse. Individuals with substance misuse were at increased risk for subsequent development of complicated grief, particularly when increases in substance consumption preceded bereavement. Conversely, complicated grief predicted increases in smoking and alcohol dependence. Multiple risk factors for individuals with complicated grief and substance misuse were identified and discussed. An existing complicated grief assessment performed well among individuals with substance misuse, and grief interventions were effective in reducing symptoms of complicated grief and substance misuse simultaneously. Given the severity of consequences associated with both conditions, more research is needed to understand this relationship, identify effective assessment tools, and evaluate intervention strategies to improve outcomes.
复杂性悲伤是一种与丧亲相关的、迁延不愈的障碍，对个体的心理和生理都有显著影响。尽管复杂性悲伤会增加物质使用障碍的发病风险，但目前对二者之间关系的了解还很有限。因此，本系统综述旨在考察物质使用障碍与复杂性悲伤之间关系的实证研究结果。我们检索了 11 个英文数据库，共获取 12 篇发表于 1997 年至 2017 年的同行评议期刊文章（N=1749）。纳入的研究评估了复杂性悲伤和物质使用障碍在有或无这两种疾病的个体中的流行率、评估方法、病因、相关性、风险因素和治疗。我们的综述结果表明复杂性悲伤与物质使用障碍之间存在正相关。有物质使用障碍的个体发生复杂性悲伤的风险增加，特别是在物质使用增加先于丧亲事件时。相反，复杂性悲伤预测了吸烟和酒精依赖的增加。本综述还确定并讨论了与复杂性悲伤和物质使用障碍共病个体相关的多种风险因素。在有物质使用障碍的个体中，现有的复杂性悲伤评估方法表现良好，且悲伤干预措施可同时有效减少复杂性悲伤和物质使用障碍的症状。鉴于这两种疾病均有严重的后果，需要更多的研究来了解这种关系，确定有效的评估工具，并评估干预策略以改善预后。
