Complicated grief impacts PTSD treatment outcomes

Naomi Simon and colleagues recently published results from an RCT comparing prolonged exposure (PE), sertraline, and their combination for combat‐related PTSD in post 9/11 veterans. In a recent publication, they used this trial data to examine the modifying effect of complicated grief (CG: a prolonged and impairing grief after the loss of a close attachment) on PTSD treatment outcomes. Twenty-four percent (46/194) of veterans had symptoms of complicated grief at treatment entry, much of which was after the loss of a fellow service member. Those with CG experienced a similar magnitude in reduction of symptoms as their peers without CG, but since those with CG had more severe PTSD symptoms at baseline they were less likely to achieve PTSD response or remission post-treatment. Although the findings need replication, the authors suggest that given the importance of CG on treatment outcomes, screening for CG is likely important for service members and veterans seeking treatment for PTSD, as is offering services specifically to veterans with CG symptoms.

Simon N et al. 2020. Understanding the impact of complicated grief on combat related posttraumatic stress disorder, guilt, suicide, and functional impairment in a clinical trial of post-9/11 service members and veterans. Depression and Anxiety, 37(1): 63-72.

Available here: https://onlinelibrary.wiley.com/doi/full/10.1002/da.22911