Rouw bij nabestaanden 8-10 jaar na suïcide*

Objective

To assess the 8-10 year course of complicated grief, depression and suicidal ideation in relatives and partners of persons who have committed suicide.

Design

Longitudinal cohort study.

Method

Relatives were recruited by the general practitioners of those who had committed suicide. We included 153 first-degree relatives and partners of 74 people who had committed suicide. Exclusion criteria were insufficient command of the Dutch language by the relatives and imprisonment of the person who had committed suicide. Half of the participating families received during the first year following the suicide family-oriented cognitive behavioural therapy; this was assigned randomly. Participants completed questionnaire 2.5 (T0), 13 (T1) and 96-120 (T2) months after the suicide. Outcome measures were complicated grief, depression and suicidal ideation. Help-seeking behaviour was also assessed. We computed prediction models with multilevel regression analysis.

Results

Complicated grief, depression, and suicidal ideation had a strong association with each other. A history of attempted suicide in relatives was associated with suicidal ideation during the period of grief (odds ratio: 5.5; 95% CI: 1.8-16.7). Depression was associated with general factors that increase the risk of depression, while the risk of complicated grief was associated with the loss of a child (regression coefficient (B): 5.5; 95% CI: 0.1-10.9). The risk of both complicated grief and depression decreased over time, but the decrease was small in the first year of the bereavement. Professional help had no effect on health risks. However, contact with others who had undergone the same experience was associated with an increased risk of complicated grief: (B: 5.9; 95% CI: 1.6-10.3).

Conclusion

Complicated grief, depression and suicidal ideation are closely associated in the course of grief following suicide. The risk of complicated grief and depression decreases over time. Contact with others who had undergone the same experience is associated with an increased risk of complicated grief. This study gives no definitive conclusions on a causal relationship between this contact and complicated grief.

Conflict of interest and financial support for this article: this study was supported by a grant from ZonMw (project number 60-60100-98-052).