Psychiatric Quarterly

, Volume 83, Issue 1, pp 65–73 | Cite as

Prevalence and Comorbidity of Prolonged Grief Disorder in a Sample of Caregivers of Patients in a Vegetative State

  • Chiara Guarnerio
  • Antonio Prunas
  • Irene Della Fontana
  • Paola Chiambretto
Original Paper

Abstract

Previous studies have shown that Prolonged Grief Disorder (PGD), Post-traumatic Stress Disorder (PTSD) and major depression are autonomous nosological entities. The present study aims at further analyzing the relationship among them in a sample of caregivers of patients in Vegetative State (VS) or Minimally Conscious State (MCS). We also investigated factors predicting the development of PGD. We sampled 40 Caregivers of patients in VS or MCS consecutively admitted to long-term care units. Caregivers were administered the PG-12, the Depression Questionnaire, the SCID I and the Davidson Trauma Scale. Six participants (15%) fulfilled the criteria for PGD, 25% (N = 10) for depression and 25% (N = 10) for PTSD. Although significant correlations emerged among symptom domains of the three disorders, no relevant association was found between a diagnosis of PGD, depression and PTSD. The severity of PTSD symptoms was found to be predictive of PGD. Clinical implications are discussed.

Keywords

Prolonged grief disorder Caregiver Vegetative state Minimally conscious state 

References

  1. 1.
    The Multi-Society Task Force on PVS: Position of neurology on certain aspects of the care and management of the persistent vegetative state patient. Neurology 39:125–126, 1989Google Scholar
  2. 2.
    Giacino J, Kalmar K: Coma Recovery Scale-Revised. The Center for Outcome Measurement in Brain Injury, 2006. http://www.tbims.org/combi/crs. Accessed August 30, 2010
  3. 3.
    Andrews K, Murphy L, Munday R, Littlewood C: Misdiagnosis of the vegetative state: Retrospective study in a rehabilitation unit. BMJ 313:13–16, 1996PubMedCrossRefGoogle Scholar
  4. 4.
    Zampolini M: GISCAR research about serious acquired brain lesions. Methodology and preliminary data. Giornale Italiano di Medicina Riabilitativa 17:15–30, 2003Google Scholar
  5. 5.
    Report of the Quality Standards Subcommittee of the American Academy of Neurology: Practice parameters: Assessment and management of patients in the persistent vegetative state. Neurology 45:1015–1018, 1995Google Scholar
  6. 6.
    Chiambretto P, Rossi Ferrario S, Zotti AM: Patients in a persistent vegetative state: Caregiver attitudes and reactions. Acta Neurologica Scandinavica 104:364–368, 2001. doi: 10.1034/j.1600-0404.2001.00107.x.PubMedCrossRefGoogle Scholar
  7. 7.
    Stern JM, Sazbon L, Becker E, Costeff H: Severe behavioural disturbance in families of patients with prolonged coma. Brain Injury 2(3):259–262, 1988PubMedCrossRefGoogle Scholar
  8. 8.
    Chiambretto P, Vanoli D: Le reazioni dei familiari allo Stato Vegetativo: un follow up a cinque anni. Giornale Italiano di Medicina del Lavoro ed Ergonomia 28(Suppl.1):15–21, 2006Google Scholar
  9. 9.
    American Psychiatric Association: DSM IV-TR: Diagnostic and statistical manual of mental disorders–Text revision, 4th edn. Washington, DC, American Psychiatric Association, 2000Google Scholar
  10. 10.
    Prigerson HG, Vanderwerker LC, Maciejewski PK: A case for inclusion of prolonged grief disorder in DSM-V. In: Stroebe M, Hanson R, Stroebe W, Stroebe HS (Eds) Handbook of Bereavement Research and Practise: 21st Century Perspectives. Washington DC, American Psychological Association Press, pp. 165–186, 2007Google Scholar
  11. 11.
    Prigerson HG: Complicate grief: When the path of adjustment leads to a dead-end. Bereavement Care 23:38–40, 2004CrossRefGoogle Scholar
  12. 12.
    Chiambretto P: Prolonged grief disorder: Verso la definizione di una nuova categoria diagnostica. Giornale Italiano di Medicina del Lavoro ed Ergonomia 30(Suppl. 3):40–46, 2008Google Scholar
  13. 13.
    Strobe M, van Son M, Strobe W, Kleber R, Schut H, van den Bout J: On the classification and diagnosis of pathological grief. Clinical Psychology Review 20:57–75, 2000CrossRefGoogle Scholar
  14. 14.
    Giacino JT: The vegetative and minimally conscious states: Consensus based on criteria for establishing diagnosis and prognosis. NeuroRehabilitation 19:293–298, 2004PubMedGoogle Scholar
  15. 15.
    Giacino JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI, Kelly JP, Rosenberg JH, Whyte J, Zafonte RD, Zasler ND: The minimally conscious state: Definition and diagnostic criteria. Neurology 58:349–353, 2002PubMedGoogle Scholar
  16. 16.
    Teasadale G, Jennett B: Assessment for coma and impaired consciousness. A practical scale. Lancet 2:81–84, 1974CrossRefGoogle Scholar
  17. 17.
    Chiambretto P, Moroni L, Guarnerio C, Bertolotti G: Validazione italiana del Prolonged Grief Disorder (PG-12). Giornale Italiano di Medicina del Lavoro ed Ergonomia 30(Suppl. 1):105–110, 2008Google Scholar
  18. 18.
    Bertolotti G, Michielin P, Vidotto G, Zotti AM, Sanavio E: Depression questionnaire (QD). In: Nezu AM, Ronan GF, Meadows EA, McKlure KS (Eds) Practitioner’s Guide to Empirical Based Measures of Depression. Norwell, MA, Kluwer Academic/Plenum Publishers, 2000Google Scholar
  19. 19.
    Davidson JRT, Book SW: Assessment of a new self-rating scale for posttraumatic stress disorder. Psychological Medicine 27:153–160, 1997PubMedCrossRefGoogle Scholar
  20. 20.
    Davidson J: Validation of the Davidson Trauma Scale. North Carolina, Duke University Medical Center, 1997Google Scholar
  21. 21.
    First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). American Psychiatric Press, Inc, Washington, DC, 1996Google Scholar
  22. 22.
    Zhang B, Mitchell SL, Bambauer KZ, Jones R, Prigerson HG: Depressive symptoms trajectories and associated risks among bereaved Alzheimer’s Disease caregivers. American Journal of Geriatric Psychiatry 16(2):145–155, 2008. doi: 10.1097/JGP.0b013e318157caec.PubMedCrossRefGoogle Scholar
  23. 23.
    Morina N, Rudari V, Bleichhardt G, Prigerson HG: Prolonged grief disorder, depression, and posttraumatic stress disorder among bereaved Kosovar civilian war survivors: A preliminary investigation. International Journal of Social Psychiatry 56(3):288–297, 2010. doi: 10.1177/0020764008101638.PubMedCrossRefGoogle Scholar
  24. 24.
    Chiambretto P, Moroni L, Guarnerio C, Bertolotti G, Prigerson HG: Prolonged grief and depression in caregivers of patients in vegetative state. Brain Injury 24(4):581–588, 2010. doi: 10.3109/02699051003610490.PubMedCrossRefGoogle Scholar
  25. 25.
    Aguglia E, Onor ML, Trevisiol M, Negro C, Saina M, Maso E: Stress in the caregivers of Alzheimer’s patients: An experimental investigation in Italy. American Journal of Alzheimer’s Disease & Other Dementias 19(4):248–252, 2004CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Chiara Guarnerio
    • 1
  • Antonio Prunas
    • 2
  • Irene Della Fontana
    • 2
  • Paola Chiambretto
    • 3
  1. 1.Clinical and Health Psychology UnitGruppo La Villa InstituteGuanzateItaly
  2. 2.Department of PsychologyMilan-Bicocca State UniversityMilanItaly
  3. 3.Clinical and Health Psychology UnitGuanzateItaly

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