Unresolved grief and its consequences. A nationwide follow-up of teenage loss of a parent to cancer 6–9 years earlier

Abstract

Purpose

The early loss of a parent is a tragedy and a serious life event. This study investigated grief resolution and morbidity in cancer-bereaved teenagers 6 to 9 years after the loss of a parent to cancer.

Methods

In a nationwide population-based study of 622 of 851 (73 %) youths who as teenagers 6 to 9 years earlier had lost a parent to cancer, we explored the magnitude of unresolved grief and its association with psychological and physiological morbidity. Participants answered a study-specific anonymous questionnaire including questions about if they had worked through their grief and about their current health.

Results

Six to nine years post-loss 49 % reported unresolved grief (8 % no and 41 % a little grief resolution). They had, in comparison with youths reporting resolved grief, statistically significantly elevated risks, e.g. for insomnia (sons’ relative risk (RR) 2.3, 95 % CI 1.3–4.0; daughters’ RR 1.7, 95 % CI 1.1–2.7), fatigue (sons’ RR 1.8, 95 % CI 1.3–2.5; daughters’ RR 1.4, 95 % CI 1.1–1.7) and moderate to severe depression, i.e. score >9, PHQ-9 (sons’ RR 3.6, 95 % CI 1.4–8.8; daughters’ RR 1.8, 95 % CI 1.1–3.1). Associations remained for insomnia in sons, exhaustion in daughters and fatigue in both sons and daughters when depression, negative intrusive thoughts and avoiding reminders of the parents’ disease or death were included in a model.

Conclusions

Approximately half of cancer-bereaved youth report no or little grief resolution 6 to 9 years post-loss, which is associated with fatigue, sleeping problems and depressive symptoms.

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Abbreviations

PHQ-9:

Patient Health Questionnaire

ICG:

Complicated grief inventory

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Acknowledgments

We thank Else Lundin and Susanne Castells for the assistance with data collection, Lawrence Lundgren for the language review and all cancer-bereaved youth for sharing their experiences with us.

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Corresponding author

Correspondence to T. Bylund-Grenklo.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. Ethical approval was obtained from the Regional Ethics Review Board, Karolinska Institute and all participants provided informed consent.

Funding

This work was supported by the Swedish Research Council (grant number 2008–4428) and the Gålö Foundation.

Conflict of interest

All authors have nothing to declare. All authors have full control over primary data.

Additional information

“It is my greatest regret today that I didn’t accept the support that was offered but let my grief grow for seven years until it wasn’t containable any longer.

Part of an advice to health-care professionals from a daughter who 8 years earlier, at age 16, lost her father to blood cancer

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Bylund-Grenklo, T., Fürst, C.J., Nyberg, T. et al. Unresolved grief and its consequences. A nationwide follow-up of teenage loss of a parent to cancer 6–9 years earlier. Support Care Cancer 24, 3095–3103 (2016). https://doi.org/10.1007/s00520-016-3118-1

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Keywords

  • Grief
  • Bereavement
  • Adolescents
  • Young adults
  • Cancer
  • Depression
  • Insomnia