Psycho-endocrinological reactions in female relatives of cancer patients. Effects of an activation programme.

Psychiatric grief reactions after the loss of a close relative are associated with endocrinological reactions, in particular elevated plasma cortisol. In the present study it was tested if a psychosocial intervention programme for relatives to cancer patients affects the reaction patterns. Thirty-six female relatives in the intervention programme were compared with 36 relatives only subjected to a routine programme. Eighteen of the relatives in the intervention programme and 17 in the routine programme experienced the death of the patient during the study period. Systematic psychiatric observations and analyses of the plasma levels of cortisol and prolactin were made approximately once a month. During the treatment period the psychiatric scores did not differ between the groups, but the prolactin levels tended to be lower in the intervention group (p = 0.06). During the terminal phase preceding the patient's death the plasma cortisol levels were significantly elevated in the intervention group but not in the routine group. At examination one and two months after the death of the patient the mental exhaustion scores were significantly lower in the intervention group. The findings are consistent with the hypothesis that grief is activated by the intervention and that the active mourning may have prophylactic value to the relatives after the death of the patient.