Study of Interpersonal Therapy and Complicated Grief Treatment in Adults 50 Years and Older

According to the National Council on Aging (1), in 2005, there were more than 10 million
older Americans who were widowed (8.6 million women (43%) and 2.1 million men (14%) over the
age of 65). These people are at risk for a debilitating reaction called Traumatic or
Complicated Grief (CG: the term now used for this condition). Studies confirm that
Complicated Grief can be reliably identified and occurs in about 10-20% of bereaved
individuals. CG appears to carry much of the risk for negative outcomes of bereavement. CG
can affect health status and influence decisions about personal health care. The risk of
hypertension is 10 times greater among widowed subjects who meet consensus criteria for CG
compared to those who do not, while subjects with CG are 17 times less likely to have
visited a physician in the months since the death. Despite its high prevalence and
significant morbidity, there are no proven efficacious treatments. The PI of this project
developed a novel psychotherapy called Complicated Grief Treatment (CGT), and has now
completed a study (MH60783) comprised of adults over age 18, that confirmed efficacy of this
approach. Participants ≥ age 60 (n=29) were less likely to be employed and more likely to
live alone. We observed better response to CGT than IPT, as in younger adults. However,
confirmation of efficacy among seniors is important, since older people have different
vulnerabilities and different problems in adjusting to grief than younger adults. We plan to
conduct a randomized controlled study of CGT v IPT in individuals > 50 years of age who meet
criteria for complicated grief and have no contraindications to study participation. Our
specific aims are: 1) To compare results of 16 sessions of either CGT or standard IPT. We
hypothesize that CGT will produce a higher response rate and shorter time to response than
IPT, and that responders will show significantly greater reduction in associated symptoms
and impairment than non-responders.

Inclusion Criteria:

- Complicated Grief is the most important problem

- Ability to give informed consent

- Fluent in English

- Willingness to have sessions audiotaped

- Willing to undergo random assignment

Exclusion Criteria:

- Diagnosis of one or more of the following disorders: Schizophrenia or other psychotic
disorder, current (past 6 months) substance abuse or positive urine toxicology exam,
Bipolar Disorder, current manic episode, Dementia

- Acute, unstable or severe medical illness such as (but not limited to) stroke,
epilepsy, or other neurodegenerative disorders, metastatic or active cancer, hepatic
disease, or primary renal disease requiring dialysis

- Pending or active disability claim or lawsuit related to the death

- Concurrent psychosocial therapy

- Judged to be at serious risk to self or others

- For people currently taking antidepressant medications, to be included in the study
they must be on the medication for at least 3 months and for at least 6 weeks on the
same dose