• Katherine Shear, Ellen Frank, Patricia R Houck, and Charles F Reynolds.
• Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pa 15213, USA. shearmk@upmc.edu
• JAMA. 2005 Jun 1; 293 (21): 260126082601-8.

ContextComplicated grief is a debilitating disorder associated with important negative health consequences, but the results of existing treatments for it have been disappointing.ObjectiveTo compare the efficacy of a novel approach, complicated grief treatment, with a standard psychotherapy (interpersonal psychotherapy).DesignTwo-cell, prospective, randomized controlled clinical trial, stratified by manner of death of loved one and treatment site.SettingA university-based psychiatric research clinic as well as a satellite clinic in a low-income African American community between April 2001 and April 2004.ParticipantsA total of 83 women and 12 men aged 18 to 85 years recruited through professional referral, self-referral, and media announcements who met criteria for complicated grief.InterventionsParticipants were randomly assigned to receive interpersonal psychotherapy (n = 46) or complicated grief treatment (n = 49); both were administered in 16 sessions during an average interval of 19 weeks per participant.Main Outcome MeasureTreatment response, defined either as independent evaluator-rated Clinical Global Improvement score of 1 or 2 or as time to a 20-point or better improvement in the self-reported Inventory of Complicated Grief.ResultsBoth treatments produced improvement in complicated grief symptoms. The response rate was greater for complicated grief treatment (51%) than for interpersonal psychotherapy (28%; P = .02) and time to response was faster for complicated grief treatment (P = .02). The number needed to treat was 4.3.ConclusionComplicated grief treatment is an improved treatment over interpersonal psychotherapy, showing higher response rates and faster time to response.

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