Buscar en
Revista Colombiana de Psiquiatría
Toda la web
Inicio Revista Colombiana de Psiquiatría Duelo, duelo patológico y terapia interpersonal
Información de la revista
Vol. 39. Núm. 2.
Páginas 375-388 (Junio 2010)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 39. Núm. 2.
Páginas 375-388 (Junio 2010)
Artículos de revisión/actualización
Acceso a texto completo
Duelo, duelo patológico y terapia interpersonal
Grief, Complicated Grief and Interpersonal Psychotherapy
Visitas
2135
Ricardo Millán-González1,
Autor para correspondencia
drmillan@hotmail.com

Correspondencia: Ricardo Millán-González, Apartado postal: 2579-2050, San Pedro, Montes De Oca, Costa Rica
, Nicolás Solano-Medina2
1 Médico psiquiatra, especialista en Psiquiatría de Enlace. Profesor de Psiquiatría de la Universidad de Costa Rica, Unidad de Neurociencias del Hospital Calderón Guardia y Centro Costarricense de Investigaciones Médicas, San Pedro, Montes de Oca, Costa Rica
2 Médico psiquiatra, Pontificia Universidad Javeriana y Clínica La Inmaculada. Bogotá, Colombia
Este artículo ha recibido
Información del artículo
Resumen
Introducción

El duelo es una reacción emocional normal ante la pérdida de un ser querido o de un estatus humano determinado. El duelo complicado es un constructo independiente que describe un cuadro clínico de mayor duración y gravedad luego de una determinada pérdida y que se considera cualitativamente distinto a los trastornos del afecto. La terapia interpersonal (TI) aborda cuatro elementos principales, uno de ellos el duelo.

Objetivo

Revisar la literatura existente sobre duelo, duelo patológico y tratamiento con terapia interpersonal.

Resultados

Algunos estudios sugieren el logro de efectos adecuados al emplear TI para el manejo de la depresión y otras entidades psiquiátricas, pero son pocos los que se centran en reacciones de duelo propiamente dicho o de duelo patológico.

Conclusiones

La mayoría de estudios de TI no distinguen entre duelo normal y patológico, así como otras entidades psiquiátricas; por lo tanto, se desconoce su utilidad en estos casos y se requiere mayor investigación que contemple estas diferencias para obtener conclusiones más firmes.

Palabras clave:
duelo
psicoterapia
literatura de revisión como asunto
Abstract
Introduction

Grief is a natural reaction human beings face when a loved one dies or a particular status is lost. Complicated grief (CG) is an independent construct that describes greater severity and longer duration as a consequence of a particular loss, which is qualitatively different from mood disorders. Interpersonal psychotherapy (IP) uses four main elements to approach patients, one of which is grief.

Objective

To review the scientific literature regarding grief, complicated grief and its treatment with IP.

Results

There are some studies that support the use of IP in the treatment of depression and other psychiatric conditions, but only a few have addressed grief or CG directly.

Conclusions

Most IP studies do not make the distinction between normal grief, CG and other mood and anxiety disorders. Thus, its real usefulness when facing this scenario is unknown. More research having in mind these differences would yield stronger conclusions.

Key words:
Grief
psychotherapy
literature review
El Texto completo está disponible en PDF
Referencias
[1]
BJ Sadock, HI Kaplan, VA Sadock.
Human development throughout the life cycle.
Kaplan and Sadock's Synopsis of Psychiatry, 10th ed., pp. 64-68
[2]
A Stoudemire, BS Fogel, D Greenberg.
Psychiatric care of the medical patient, 2nd ed., Oxford University Press, (2000),
[3]
R Morla-Boloña.
Duelo.
Psiquiatría Clínica: diagnóstico y tratamiento en niños, adolescente y adultos, 3a ed., pp. 332-336
[4]
DM Clarke, AJ Mackinnon, GC Smith, DP Mckenzie, HE Herrman.
Dimensions of psychopathology in the medically ill: a latent trait analysis.
Psychosomatics, 41 (2000), pp. 418-425
[5]
A Alarcón-Prada.
Aspectos psicosociales del paciente renal, 2a ed., La Silueta, (2004),
[6]
TA Stern, GL Fricchione, NH Cassem, MS Jellinek, JF Rosenbaum.
Handbook of General Hospital Psychiatry, 5a ed., Mosby, (2004),
[7]
MR Brown, B Sourkes.
Psychotherapy in pediatric palliative care.
Child Adolesc Psychiatric Clin N Am, 15 (2006), pp. 585-596
[8]
CH Ott, RJ Lueger, ST Kelber, HG Prigerson.
Spousal bereavement in older adults common, resilient, and chronic grief with defining characteristics.
J Nerv Ment Dis, 195 (2007), pp. 332-341
[9]
A Germain, K Shear, TH Monk, PR Houck, CF Reynolds, E Frank, et al.
Treating complicated grief: effects on sleep quality.
Behav Sleep Med, 4 (2006), pp. 152-163
[10]
L Dillen, JR Fontaine, L Verhofstadt-Denève.
Confirming the distinctiveness of complicated grief from depression and anxiety among adolescents.
Death Stud, 33 (2009), pp. 437-461
[11]
PA Boelen, J van den Bout.
Complicated grief, depression, and anxiety as distinct postloss syndromes: a confirmatory factor analysis study.
Am J Psychiatry, 162 (2005), pp. 2175-2177
[12]
NM Melhem, G Moritz, M Walker, MK Shear, D Brent.
Phenomenology and correlates of complicated grief in children and adolescents.
J Am Acad Child Adolesc Psychiatry, 46 (2007), pp. 493-499
[13]
LC Vanderwerker, SC Jacobs, CM Parkes, HG Prigerson.
An exploration of associations between separation anxiety in childhood and complicated grief in later life.
J Nerv Ment Dis, 194 (2006), pp. 121-123
[14]
JG Johnson, B Zhang, JA Greer, HG Prigerson.
Parental control, partner dependency, and complicated grief among widowed adults in the community.
J Nerv Ment Dis, 195 (2007), pp. 26-30
[15]
American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, 4th ed., American Psychiatric Press, (2000),
[16]
World Health Organization.
International Statistical Classification of Diseases and Related Health Problems 10th Revision Version for 2007: Chapter V: Mental and Behavioral Disorders [Internet]. World Health Organization. [Citado el 2009 Abril 01].
[17]
M Maj.
Are we able to differentiate between true mental disorders and homeostatic reactions to adverse life events?.
Psychother Psychosom, 76 (2007), pp. 257-259
[18]
JM Currier, JM Holland, RA Neimeyer.
The effectiveness of bereavement interventions with children: a meta-analytic review of controlled outcome research.
J Clin Child Adolesc Psychol, 36 (2007), pp. 253-259
[19]
S Büchi, H Mörgeli, U Schnyder, J Jenewein, A Glaser, JC Fauchere, et al.
Shared or discordant grief in couples 2-6 years after the death of their premature baby: effects on suffering and posttraumatic growth.
Psychosomatics, 50 (2009), pp. 123-130
[20]
V Flenady, T Wilson.
Support for mothers, fathers and families after perinatal death.
Cochrane Database Syst Rev, 23 (2008),
[21]
CR Marmar, MJ Horowitz, DS Weiss, NR Wilner, NB Kaltreider.
A controlled trial of brief psychotherapy and mutual-help group treatment of conjugal bereavement.
Am J Psychiatry, 145 (1988), pp. 203-209
[22]
WE Piper, M McCallum, AS Joyce, JS Rosie, JS Ogrodniczuk.
Patient personality and time-limited group psychotherapy for complicated grief.
Int J Group Psychother, 51 (2001), pp. 525-552
[23]
WE Piper, JS Ogrodniczuk, C Lamarche, T Hilscher, AS Joyce.
Level of alliance, pattern of alliance, and outcome in short-term group therapy.
Int J Psychother, 55 (2005), pp. 527-550
[24]
MJ Horowitz, C Marmar, DS Weiss, KN DeWitt, R Rosenbaum.
Brief psychotherapy of bereavement reactions. The relationship of process outcome.
Arch Gen Psychiatry, 41 (1984), pp. 438-448
[25]
H Levenson, S Butler, T Powers, B Beitman.
Interpersonal psychotherapy for patients with depression.
Brief dynamic and interpersonal therapy, 2nd ed., pp. 55-74
[26]
JL Cutler, A Goldyne, JC Markowitz, MJ Devlin, RA Glick.
Comparing cognitive behavior therapy, interpersonal psychotherapy, and psychodynamic psychotherapy.
Am J Psychiatry, 161 (2004), pp. 1567-1573
[27]
DE Wilfley.
Interpersonal psychotherapy.
Kaplan and Sadock's comprehensive textbook of psychiatry, 8a ed., pp. 2610-2619
[28]
G Sloan, J Hobson, J Leighton, B McFarlane, R Law.
An overview and history of interpersonal psychotherapy.
Nursing Standard, 23 (2009), pp. 44-49
[29]
SE Luty, PR Joyce, RT Mulder, PF Sullivan, JM Mckenzie.
Relationship between interpersonal psychotherapy problem areas with temperament and character: a pilot study.
Depress Anxiety, 8 (1998), pp. 154-159
[30]
AC Andrade, E Frank, F Lotufo-Neto, PR Houck.
An adaptation of the interpersonal problem areas rating scale: pilot and interrater agreement study.
Rev Bras Psiquiatr, 30 (2008), pp. 353-357
[31]
MM Weissmann.
Cognitive therapy and interpersonal psycotherapy: 30 years later.
Am J Psychiatry, 164 (2007), pp. 693-696
[32]
H Verdeli.
Toward building feasible, efficacious and sustainable treatments for depression in developing countries.
Depress Anxiety, 25 (2008), pp. 899-902
[33]
JD Lipsitz, JC Markowitz, S Cherry, AJ Fyer.
Open trial of interpersonal psychotherapy for the treatment of social phobia.
Am J Psychiatry, 156 (1999), pp. 1814-1816
[34]
KL Bleiberg, JC Makowist.
A pilot study of interpersonal psychotherapy for posttraumatic stress disorders.
Am J Psychiatry, 162 (2005), pp. 181-183
[35]
A Spyropoulou, I Zervas, A Leonardou, A Gregoriou, H Verdeli.
Preliminary data on the use of interpersonal psychotherapy for menopausal depression. Women's Mental Health Clinic. 8th European Congress on Menopause.
Maturitas, 63 (2009), pp. S1-S136
[36]
MG Spinelli, J Endicott.
Controlled clinical trail of interpersonal psychotherapy versus parenting education program for depressed pregnant women.
Am J Psychiatry, 160 (2003), pp. 555-562
[37]
C Zlotnick, SL Johnson, IW Miller, T Pearlstein, M Howard.
Postpartum depression in women receiving public assistance: pilot study of an interpersonal-therapy-oriented group intervention.
Am J Psychiatry, 158 (2001), pp. 638-640
[38]
E Frank, DJ Kupfer, JM Perel, C Cornes, DB Jarrett, AG Mallinger, et al.
Three-year outcomes for maintenance therapies in recurrent depression.
Arch Gen Psychiatry, 47 (1990), pp. 1093-1099
[39]
E Frank, DJ Kupfer, DJ Buysse, HA Swartz, PA Pilkonis, PR Houck, et al.
Randomized trial of weekly, twice-monthly, and monthly interpersonal psychotherapy as maintenance treatment for women with recurrent depression.
Am J Psychiatry, 164 (2007), pp. 761-767
[40]
E Schramm, D van Calker, P Dykierek, K Lieb, S Kech, I Zobel, et al.
An intensive treatment program of interpersonal psychotherapy plus pharmacotherapy for depressed inpatients: acute and long-term results.
Am J Psychiatry, 164 (2007), pp. 768-777
[41]
HA Swartz, E Frank, A Zuckoff, JM Cyranowski, PR Houck, Y Cheng, et al.
Brief interpersonal psychotherapy for depressed mothers whose children are receiving psychiatric treatment.
Am J Psychiatry, 165 (2008), pp. 1155-1162
[42]
JC Markowitz, GL Klerman, SW Perry.
Interpersonal psychotherapy of depressed HIV-positive outpatients.
Hosp Community Psychiatry, 43 (1992), pp. 885-890
[43]
S Stuart, R Noyes Jr.
Interpersonal psychotherapy for somatizing patients.
Psychother Psychosom, 75 (2006), pp. 209-219
[44]
CF Reynolds 3erd, MA Dew, BG Pollock, BH Mulsant, E Frank, MD Miller, et al.
Maintenance treatment of major depression in old age.
N Engl J Med, 354 (2006), pp. 1130-1138
[45]
K Carreira, MD Miller, E Frank, PR Houck, JQ Morse, MA Dew, et al.
A controlled evaluation of monthly maintenance Interpersonal Psychotherapy in late-life depression with varying levels of cognitive function.
Int J Geriatr Psychiatry, 23 (2008), pp. 1110-1113
[46]
I Sakinofsky.
The aftermath of suicide: managing survivors’ bereavement.
Can J Psychiatry, 52 (2007), pp. 129S-136S
[47]
K Shear, E Frank, PR Houek, CF Reynolds 3rd.
Treatment of complicated grief: a randomized controlled trial.
JAMA, 293 (2005), pp. 2601-2608
[48]
D Spiegel, C Classen.
Group therapy for cancer patients: a research-based handbook of psychosocial care, 1st ed., Basic Books, (2000),
[49]
JM Donnellya, AB Kornblith, S Fleishmanc, E Zuckermand, G Raptis, CA Hudis, et al.
A pilot study of interpersonal psychotherapy by telephone with cancer patients and their partners.
Psychooncology, 9 (2000), pp. 44-56
[50]
C Lethborg, S Aranda, S Cox, D Kissane.
To what extent does meaning mediate adaptation to cancer? The relationship between physical suffering, meaning in life, and connection to others in adjustment to cancer.
Palliat Support Care, 5 (2007), pp. 377-388
[51]
K Mystakidou, E Tsilika, E Parpa, A Galanos, L Vlahos.
Screening for preparatory grief in advanced cancer patients.
[52]
R Ranmal, M Prictor, JT Scott.
Interventions for improving communication with children and adolescents about their cancer.
Cochrane Database Syst Rev, (2008),
[53]
Aulí J. Comunicación personal sobre manejo del duelo en familias con un(a) niño(a) con cáncer. 2009.
[54]
R Neugebauer, J Kline, K Bleiberg, L Baxi, JC Markowitz, M Rosing, et al.
Preliminary open trial of interpersonal counseling for subsyndromal depression following miscarriage.
Depression and Anxiety, 24 (2007), pp. 219-222
[55]
CR Reynolds 3rd, E Frank, PR Houck, S Mazumdar, MA Dew, C Cornes, et al.
Which elderly patients with remitted depression remain well with continued interpersonal psychotherapy after discontinuation of antidepressant medication?.
Am J Psychiatry, 154 (1997), pp. 958-962

Conflicto de interés: los autores manifiestan que no tienen ningún conflicto de interés en este artículo.

Copyright © 2010. Asociación Colombiana de Psiquiatría
Opciones de artículo
Herramientas