Suicide of friend often very traumatic for teens

Teens with a friend who commits suicide are at risk of an intense reaction called traumatic grief, which in turn renders them prone to subsequent mental disturbances, new research shows.

"In other words," study author Dr. Nadine Melhem told Reuters Health, "adolescents who experience traumatic grief are at higher risk to develop depression or posttraumatic stress disorder at a later point in time than those who do not experience traumatic grief."

Melhem, who is based at the Western Psychiatric Institute and Clinic and the University of Pittsburgh School of Medicine, added that she hopes these results inspire clinicians to become more aware of the occurrence of traumatic grief, and the need to address the condition when treating a grieving teen.

Everybody grieves when they lose a close friend or loved one, but research shows that traumatic grief can also affect functioning, and people with the condition tend to have poorer physical health and fantasize about suicide more often than people who don't have such an intense reaction.

Researchers have investigated traumatic grief in adults, but have done little to assess the condition in children and teens.

For their study, Melhem and her colleagues interviewed 146 adolescent friends and acquaintances of 26 people who had committed suicide. Participants were interviewed 6 months, 12 to 18 months, and 36 months after the suicide. A small group was also contacted 6 years later.

Reporting in the American Journal of Psychiatry, the investigators found that approximately 25 percent of teens were suffering from traumatic grief 6 months after the suicide, while only 7 percent showed signs of the condition 3 years later.

Teens with traumatic grief tended to experience a cluster of symptoms, including crying, yearning, numbness, a preoccupation with their deceased friend, and poor adjustment to the loss.

Those with traumatic grief were also more likely to later show signs of depression and post-traumatic stress disorder (PTSD).

"Traumatic grief predicts the occurrence of depression and post-traumatic stress disorder," Melhem said.

In the report, Melhem and her team note that the adolescents included in the current study had a higher-than-average rate of psychiatric problems before their friends' deaths, putting them at higher risk of coping problems. Consequently, they suggest that these teens may not represent the average teens' reaction to the death of a loved one.

SOURCE: American Journal of Psychiatry, August 2004.