Suicide: Bereavement Course in Close Relatives and Spouses

Marieke de Groot, PhD Senior Researcher University of Groningen/University Medical Center Groningen VU University Amsterdam, department of Clinical Psychology The EMGO Institute for Health and Care Research (EMGO+)MedicalResearch.com Interview with:
Marieke de Groot, PhD
Senior Researcher
University of Groningen/University Medical Center Groningen
VU University Amsterdam, department of Clinical Psychology
The EMGO Institute for Health and Care Research (EMGO+)

MedicalResearch.com: What are the main findings of the study?

Answer: We investigated the long term course of bereavement through suicide in a community-based sample of 153 first-degree relatives and spouses of 74 suicide cases. Outcome measures were complicated grief, depression and suicide ideation. We found that outcomes are mutually strongly associated over the 8-10 years course. A history of attempted suicide predicts a increased risk of suicide ideation during the bereavement course. Depression is more likely predicted by factors generally associated with a increased risk of depression such as female gender and low mastery, whereas complicated grief is more likely predicted by the trauma of losing a child due to suicide. No significant associations were found between outcomes and the use of help resources except for mutual (or peer) support, which is associated with a increased risk of complicated grief. Time is the only factor (included in this study) predicting decrease of the risk of depression and complicated grief.

MedicalResearch.com: Were any of the findings unexpected?

Answer: The increased risk of complicated grief among relatives who had received peer-support is a rather unexpected finding, as we expected that there would be no significant association between bereavement outcome and help resources.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: Although no conclusion can be drawn about a causal association between peer-support and complicated grief, the outcome show that recommending peer support (but no other help resource) to suicide bereaved relatives with a pre-existent vulnerabilty for developing depression or suicide ideation, or with emerging symptoms of these factors and of complicated grief may be contraproductive.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: It would be of interest to investigate the mechanisms underlying the association between complicated grief, depression and suicide ideation. In the reference of complicated grief treatment it would be of interest whether suicide ideation is a cause or a consequence of complicated grief. The outcomes suggest two possible pathways; effective mourning may be inhibited by suicide ideation causing complicated grief, or, bereaved individuals develop suicide ideations due to enduring symptoms of complicated grief.

Citation:

Course of bereavement over 8-10 years in first degree relatives and spouses of people who committed suicide:
longitudinal community based cohort study

de Groot M ,Kollen BJ. Course of bereavement over 8-10 years in first degree relatives and spouses of people who committed suicide: longitudinal community based cohort study. BMJ 2013;347:f5519