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Risk factors
By Mayo Clinic staffWhile it's not known specifically what causes complicated grief, researchers continue to learn more about the factors that may increase the risk of developing it. These risk factors may include:
- An unexpected or violent death
- Suicide of a loved one
- Lack of a support system or friendships
- Traumatic childhood experiences, such as abuse or neglect
- Childhood separation anxiety
- Close or dependent relationship to the deceased person
- Being unprepared for the death
- In the case of a child's death, the number of remaining children
- Lack of resilience or adaptability to life changes
References
- Bereavement. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed July 13, 2009.
- Lipsitz JD. Interpersonal theory of depression. Gabbard GO, ed. Textbook of Psychotherapeutic Treatments. Arlington, VA: American Psychiatric Publishing; 2009. http://www.psychiatryonline.com. Accessed July 13, 2009.
- Marchand L. End-of-life care. In: Rakel RE. Rakel: Textbook of Family Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/149504704-3/862284999/1494/128.html#4-u1.0-B978-1-4160-2954-0..50085-5_4160. Accessed July 13, 2009.
- Block SD. Grief and bereavement. http://www.uptodate.com/home/index.html. Accessed July 13, 2009.
- Kendler KS, et al. Does bereavement-related major depression differ from major depression associated with other stressful life events? American Journal of Psychiatry.2008;165:1449.
- Abrahm JL. Caring for patients at the end of life. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/149504704-4/862286866/1709/49.html#4-u1.0-B978-0-443-06694-8..50048-8_1340. Accessed July 13, 2009.
- Siegel MD, et al. Psychiatric illness in the next of kin of patients who die in the intensive care unit. Critical Care Medicine. 2008;36:1722.
- Complicated grief. National Cancer Institute. http://www.nci.nih.gov/cancertopics/pdq/supportivecare/bereavement/Patient/page8. Accessed July 13, 2009.
- Major depression and complicated grief. American Cancer Society. http://www.cancer.org/docroot/MBC/content/MBC_4_1X_Major_Depression_and_Complicated_Grief.asp. Accessed July 13, 2009.
- Simon NM, et al. Complicated grief: A case series using escitalopram. American Journal of Psychiatry. 2007;164:1760.
- Prigerson HG, et al. Inventory of complicated grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research. 1995;59:65.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. July 15, 2009.
