The Center for Psycho-oncology and
Palliative Care Research

Contact Information

Holly Gwen Prigerson, PhD
Dana-Farber Cancer Institute
44 Binney Street
Shields Warren 440A
Boston, MA 02115
USA
Office phone: (617) 632-2369
Appointment phone: (617) 632-2369
Fax: (617) 582-8017
E-mail: Holly_Prigerson@dfci.harvard.edu
Preferred contact method: e-mail

Research

Our research focuses on factors that affect the quality of life and care of cancer patients and their family caregivers. A major focus of our research has been on the mental health of bereaved cancer patient caregivers. More specifically, we have conducted a series of studies that have identified "complicated grief" as a distinct psychiatric disorder. Using data from epidemiologic, pharmacological, psychotherapeutic and EEG sleep studies -- as well as clinical cases histories -- we have identified a set of symptoms that: (1) are separate from symptoms of depression and anxiety, (2) have distinctive risk factors and clinical correlates, (3) become chronic in a significant minority of bereaved persons, (4) predict enduring morbidity, and (5) require specialized treatment. Our recently completed field trial of consensus criteria for complicated grief derived reliable and valid diagnostic criteria (proposed for inclusion in DSM-V) for distinguishing between normal and more difficult patterns of bereavement adjustment.

Efforts are underway to translate new insights from bereavement research into the development and testing of interventions to reduce the distress and morbidity associated with bereavement. These include the development of an online, interactive module to promote adjustment in the early post-loss period, and randomized controlled trials of pharmacotherapies for complicated grief.

The Center for Psycho-oncology and Palliative Care Research focuses on the following core areas:

-- Clinical epidemiologic studies of the prevalence, risk factors, diagnosis, and outcomes of disorders common in cancer patients, including depression and delirium (and their interaction with pain management).

-- Health services research, such as factors influencing access, quality, and cost-effectiveness of mental health and other services in cancer patients and their families.

-- Doctor-patient-family communications and behaviors, such as conveying information about prognoses and other bad news.

-- Studies of the neurobiology of stress and resilience in the context of cancer (e.g., studying neuroendocrine mechanisms of underlying grief).

-- Physician factors affecting the delivery of care at the end of life, and the development of interventions targeted at these factors.

-- Sociodemographic factors (e.g., race/ethnicity, gender, education) that contribute to disparities in cancer care

Biography

Dr. Holly Prigerson received her PhD in 1990 from Stanford University. She then completed a National Institutes of Health postdoctoral fellowship in the epidemiology of aging at Yale University School of Medicine, where she later became an assistant professor of psychiatry and then associate professor of psychiatry in the Department of Epidemiology and Public Health. In 2004, she became director of the Center for Psycho-Oncology and Palliative Care Research at DFCI.

Select Publications

* Chen JH, Gill Tm, Prigerson HG. Health behaviors associated with better quality of life for older bereaved persons. J Palliat Med 2005:8:96-106.
* Vanderwerker LC, Laff R, Kadan-Lottick N, Prigerson HG. Psychiatric disorders and mental health service use in caregivers of advanced cancer patients. J Clin Oncol 2005; IN PRESS.
* Bradley EH, Prigerson HG, Carlson M, Cherlin E, Kasl SV, Hurzeler-Johnson R. Does length of hospice enrollment affect depression among surviving caregivers? Am J Psychiatry 2004;161:2257-62.
* Ganzini L, Prigerson HG. The other side of the slippery slope. Hastings Cent Rep 2004;34:3.
* Latham AE, Prigerson HG. Suicidality and bereavement: complicated grief as psychiatric disorder presenting greatest risk for suicidality. Suicide Life Threat Behav 2004;34:350-63.
* Prigerson HG. Costs to society of family caregiving for patients with end-stage Alzheimer's disease. N Engl J Med 2003;349:1891-2.
* Prigerson HG, Bradley EH, Kasl SV, Jacobs SC. Good death: an oxymoron without mental health. BMJ 2003;327:222.
* Prigerson HG, Cherlin E, Chen JH, Kasl SV, Hurzeler R, Bradley EH. Stressful caregiving adult reactions to experiences of dying (SCARED) scale. Am J Geriatr Psychiatry 2003;11:309-19.

Instructors

Lauren Vanderwerker, PhD