Effects of financial status on major depressive disorder and complicated grief among bereaved family members of patients with cancer.

Abstract

To examine current financial status, changes before and after bereavement, and their effects on possible major depressive disorder (MDD) and complicated grief (CG) among bereaved family members of patients with cancer. We conducted a nationwide cross-sectional questionnaire survey on 787 bereaved family members of patients with cancer in 71 palliative care institutions in Japan from May to July 2016. The survey assessed perceived level of concern regarding current financial status and whether it changed after bereavement. We also collected information on demographic factors and assessed the possible MDD and CG using the Patient Health Questionnaire-9 and Brief Grief Questionnaire, respectively. We then conducted bivariate analysis to examine the relationship between these factors and financial status. A total of 491 (62%) questionnaires were returned. The majority of the participants (n=382, 78%) reported having no or mild concerns about their livelihood, whereas 19% (n=95) had moderate to severe concerns. Regarding the change in financial status after bereavement, 7% (n=35) reported improvement, 28% (n=131) reported worsening, and 65% (n=308) reported no change. The prevalences of possible MDD and CG were 22% (n=108) and 9% (n=41), respectively, and were significantly lower among participants with less concern regarding their livelihood and whose financial status had not changed after bereavement (both p<0.05). About one-fifth of the bereaved family members reported financial difficulties to some extent; these were significantly associated with MDD and CG. These findings provide evidence of the need for psychosocial support including financial consultation for bereaved family members.