54 An open-label pilot study suggested that selective serotonin reuptake inhibitors may be sufficient to treat CG even in the absence of psychotherapy.5 Because CGT is a challenging treatment not yet widely available, a finding that medication alone is sufficient to alleviate suffering in many individuals would have important public health significance.

Currently, a large-scale trial is underway in four sites to investigate these questions. Clients with CG as indicated by a score of 0 or more on the Inventory of Inhibitors,research,lifescience,medical Complicated Grief59 are randomly assigned to citalopram, pill placebo, CGT plus placebo, or CGT plus citalopram. The primary aim is to determine whether citalopram is more effective than placebo in reducing the symptoms of CG, as measured by the Clinician Global Impression – Improvement.60 Another area ripe for exploration is the disseminability of CGT. Drawing as it does from both IPT and CBT, it can be challenging to learn for therapists Inhibitors,research,lifescience,medical who have a strong background in one model but not in the other. Like other therapies that deal with intense pain, it can Inhibitors,research,lifescience,medical also

be emotionally draining. To date, the process for obtaining the requisite skills to conduct CGT competently has involved a multi-day didactic workshop followed by intensive supervision of at least two cases, with an expert supervisor listening to audiotapes on an hour-for-hour basis. This level of training and supervision may not be readily available for all potential therapists. It would be of interest to investigate whether a less stringent, time -intensive training process is sufficient to produce good outcomes; such a finding would greatly increase the public health Inhibitors,research,lifescience,medical significance of this promising new therapy.
Complicated

grief (CG) is a disorder of significant impact1, Inhibitors,research,lifescience,medical as described in other articles in the current issue. An important question with which psychiatrists, ABT-888 in vitro researchers, the DSM-5 committee, and the general public have wrestled is how to address the unique suffering of those with CG, and how to distinguish it from acute grief, which may also cause difficult emotional reactions. The either present article reviews what is known about the immunologic and neuroimaging biomarkers of both acute grief and CG. Evidence from the past three decades has indicated that immunological changes occur in those who have experienced the death of a loved one, which may impact physical health. Newer evidence suggests which neural regions are activated in response to grief cues. Although only empirically defined as a disorder in the past two decades, recent research has compared CG with noncomplicated grief (non-CG) to determine whether severity of grief may have greater explanatory power than the demographic category of bereaved/nonbereaved.