Sophia made good progress over 16 weeks of CGT

and her ICG score dropped to 23 and her QIDS score to 5. Sophia said the thing she missed the most was coming home to tell her husband all about her day’s activities and, although she felt demoralized before CGT to the point of considering suicide despite having other caring family remaining, she said what helped her the most in CGT was learning to take stock of her life with its current limitations (including some of her own health problems), to become Inhibitors,research,lifescience,medical closer to her children and grandchildren, to volunteer more and to schedule theater trips and other entertainment with a group of other women, some of whom were also widows and who were “worse off than me.” Complicated grief, major depression,

Inhibitors,research,lifescience,medical and antidepressant medication It has been said that “grief is not a disease but it can become one.” In DSM TV-TR, a diagnosis of major depression is excluded in the context of grieving within the first 2 months. Furthermore, common features of grief such as sadness, BIBW2992 supplier social withdrawal, sleep disturbance, rumination, and loss of pleasure in usual activities can also be symptoms of depression, which often perplexes primary care physicians about whether to treat a natural phenomenon with antidepressant medication versus not treating Inhibitors,research,lifescience,medical disabling psychopathology. Several studies have shown that Inhibitors,research,lifescience,medical antidepressant medication can relieve depressive symptoms that are bereavement-related. For example, Zisook treated bereaved individuals with major depression with bupropion and saw a robust response in reducing depression but only modest decreases in grief severity.16 Zygmont applied a combination of grief-focused psychotherapy and paroxetine in 15 subjects with complicated grief also found a modest reduction in grief intensity.17 Pasternak18 randomized depressed elders to nortriptyline vs placebo and showed that although depressive

Inhibitors,research,lifescience,medical symptoms improved significantly better in the nortriptyline-treated group compared with those receiving placebo, the intensity of grief symptoms measured by the Texas Revised Inventory of Grief19 did not change appreciably. Reynolds et al randomized elders with bereavement-related major depression twice to receive nortriptyline vs placebo mafosfamide and also IPT vs Clinical Management (empathic support but no specific therapy) and showed that the nortriptyline-treated group showed a significantly higher remission rate than the placebo group but no added benefit for IPT (probably due to an undetectable effect size in this sample of only 80 subjects).1 In the cohort comparing IPT and CGT for CG mentioned earlier,2 Simon and colleagues analyzed the contributing effect of antidepressant medication, which was allowed to continue unchanged during the study if it was already prescribed at baseline.