Materiały źródłowe

• #1 Bereavement and Complicated Grief

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3855369/

  Bereavement is a common experience in adults age 60 and older. […] About 7% of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). […] This article reviews recent publications on the diagnosis of CG, risk factors for the condition, and evidenced-based treatments for CG. Greater attention to complicated grief detection and treatment in older adults is needed. […] For most bereaved older adults, the health and emotional consequences of bereavement resolve in a few months, and pre-loss functioning is restored. However, for a clinically significant minority, complications derail the natural mourning process and prolong acute grief, resulting in a mental health condition. […] A recent population-based survey found 6.7% of bereaved individuals develop CG, and individuals 61 and older had more than double the rate (9%) of younger adults.

• #2 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  PGD is estimated to be experienced by about 10 percent of bereaved survivors, although rates vary substantially depending on populations sampled and definitions used. […] According to a 2017 meta-analysis, prevalence of prolonged grief is estimated to be 9.8%, although higher prevalence estimates, as high as 49%, are possible if the death was not due to natural causes. […] PGD is also more prevalent when the death is by a violent method such as homicide or suicide, with an estimated 70% of those with PGD in the study having been exposed to bereavement by a violent method. […] Conversely, PGD is less common in cases where the bereaved death was due to natural disasters. […] PGD has higher prevalence in women. […] A 2021 meta-analysis identified a global prevalence of 14.2% in prolonged grief disorders among bereaved families dealing with cancer-related deaths.

• #3 Prolonged grief disorder is now in the DSM. Here’s what you need to know. – The Washington Post

  https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/

  PGD can be diagnosed no sooner than one year after the death of a loved one, and it is defined by a daily, intense yearning for the deceased or a preoccupation with thoughts or memories of them. […] Although PGD is newly designated as a disorder, similar conditions have been documented and investigated for many years, usually called “complicated grief.” […] About 1 in 10 people who have lost someone struggle with PGD. […] “People ask us, ‘Am I going crazy?’ all the time, and having PGD recognized will validate their suffering and show them there are others suffering in a similar way,” said Natalia Skritskaya, a clinical psychologist and associate research scientist at Columbia’s Center for Complicated Grief. […] Although PGD shares some symptoms with depression and post-traumatic stress disorder, it is “neurobiologically and epidemiologically different,” Prigerson said.

• #4

  https://link.springer.com/article/10.1007/s00127-023-02469-1

  Prolonged Grief Disorder (PGD) is a new disorder included in ICD-11 (WHO, 2018). There is a growing body of literature surrounding the prevalence and correlates of ICD-11 PGD symptoms as assessed using various measures. This study was the first to assess levels of ICD-11 PGD symptoms as measured by the International Prolonged Grief Disorder Scale (IPGDS), a self-report scale directly aligned with the ICD-11 definition of PGD, among the United Kingdom adult general population, and identify correlates. […] Prevalence rates of PGD were estimated based on two commonly used algorithms defined as strict and moderate. […] It was found that 2.4% (n=43) of participants met probable caseness for PGD using the strict criteria while 7.9% (n=140) met probable caseness for PGD using the moderate criteria.

• #5

  https://link.springer.com/article/10.1007/s00127-023-02469-1

  Results demonstrated that common features of PGD in the UK population (at the moderate and strict level) include longing and preoccupation with the deceased, intense sadness, and loss of identity. […] These findings suggested that the prevalence of ICD-11 PGD was between 2.4 and 8%. […] The variability in prevalence rates and risk factors when using the moderate and strict diagnostic algorithms emphasizes the need for an agreed upon expert consensus as to which algorithm to carry forward.

• #6 Bereavement and Complicated Grief

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3855369/

  Bereavement is a common experience in adults age 60 and older. […] About 7% of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). […] This article reviews recent publications on the diagnosis of CG, risk factors for the condition, and evidenced-based treatments for CG. Greater attention to complicated grief detection and treatment in older adults is needed. […] For most bereaved older adults, the health and emotional consequences of bereavement resolve in a few months, and pre-loss functioning is restored. However, for a clinically significant minority, complications derail the natural mourning process and prolong acute grief, resulting in a mental health condition. […] A recent population-based survey found 6.7% of bereaved individuals develop CG, and individuals 61 and older had more than double the rate (9%) of younger adults.

• #7 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  In older adults, prolonged grief can affect as many as a quarter of those suffering a loss, according to a 2011 study, while a 2014 study in JAMA Psychiatry stated that about 9 percent of bereaved older women, defined as women over the age of 65, experience prolonged grief. […] After this pandemic, rates of prolonged grief among older adults may move even higher, says Simon, but given the DSM-5s requirement that grief persist for twelve months following a loss, not enough time has elapsed for data to be assessed. […] Yet, caregivers like Simon are preparing. A June 2020 letter in Psychiatry Research issued an early warning that increased rates of prolonged grief may be expected considering the circumstances of many COVID-19 deaths in which symptoms of prolonged grief are typically elevated when deaths are unexpected, traditional grief rituals (e.g., saying goodbye, viewing, and burial of the body) are absent, and physical social support is lacking.

• #8 Complicated Grief | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/complicated-grief/

  Complicated grief affects between 2% to 3% of the population worldwide and 7% to 10% of bereaved people. […] This condition is characterized by intense grief that lasts longer than would be normally expected and that impairs daily functioning. […] Complicated grief can follow the loss of any close relationship, especially after the death of a romantic partner and among parents who have lost a child. […] Risk factors include a history of mood or anxiety disorders, alcohol or drug abuse, and multiple losses. […] Depression in persons who have been caregivers during a loved one’s terminal illness and those who had depression early in bereavement are more likely to develop complicated grief later in bereavement. […] There are two approaches: one deals with complicated grief; the other gives us strategies for accepting the loss and for restoring a sense of the possibility of future happiness.

• #9 Fire Fighter Death: The Difference Between Normal Grief and Complicated Grief | IAFF Recovery Center

  https://www.iaffrecoverycenter.com/blog/the-difference-between-normal-grief-and-complicated-grief

  Certain factors can put individuals at particularly high risk of complicated grief. These include: Lack of familial or social support, Death of a spouse or child, History of mental health struggles, Grief associated with a violent or traumatic death. […] But when complicated grief begins to take hold, its important to seek help sooner rather than later. Early intervention can help individuals work through loss, and learn how to live fulfilling, meaningful lives despite personal tragedy. […] If left untreated, complicated grief can transform into other problems, including depression and addiction.

• #10 Bereavement and Complicated Grief | Ausmed

  https://www.ausmed.com/learn/articles/bereavement-and-complicated-grief

  Most people experiencing bereavement will come to cope with their loss over time. However, in some cases, grief is so debilitating that the bereaved person will have difficulty recovering from the loss and resuming their life, even after a significant period of time. This is known as complicated grief or persistent complex bereavement disorder (Mayo Clinic 2022). […] Complicated grief negatively impacts a persons relationships, employment and life. It is generally characterised by a sustained intensity of grief over a very long period of time (Mayo Clinic 2022). […] Risk factors for complicated grief include: Traumatic loss, Sudden loss, Witnessing the death, Not being present during the death, The loss of a child, Having a close relationship with the deceased person, Multiple losses, either over time or all at once, A history of depression, separation anxiety or post-traumatic stress disorder (PTSD), Coexisting stressors, e.g. financial hardship, An insecure childhood, Early separation from one or both parents, Insomnia (Mayo Clinic 2022; Ohwovoriole Block 2024).

• #11 Prolonged grief disorder is now in the DSM. Here’s what you need to know. – The Washington Post

  https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/

  PGD puts people at higher risk for medical problems (cancer, high blood pressure, heart or immunological issues), other mental health disorders, disability, hospitalization and suicide. […] Research has identified several factors that complicate grief. […] “Sudden and traumatic deaths, and deaths by suicide, are more likely to lead to complicated grief,” Skritskaya said. […] Treatments for complicated grief have been investigated since the late 1990s and practiced for much longer. […] “Research showed that neither antidepressants nor standard depression-focused therapy are very effective for complicated grief,” Shear said. […] A 2014 Australian study found that grief-focused cognitive behavior therapy helped those with PGD. […] While psychotherapy is a first-line treatment for PGD, antidepressants can be helpful with the depression that often accompanies complicated grief.

• #12 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  PGD is estimated to be experienced by about 10 percent of bereaved survivors, although rates vary substantially depending on populations sampled and definitions used. […] According to a 2017 meta-analysis, prevalence of prolonged grief is estimated to be 9.8%, although higher prevalence estimates, as high as 49%, are possible if the death was not due to natural causes. […] PGD is also more prevalent when the death is by a violent method such as homicide or suicide, with an estimated 70% of those with PGD in the study having been exposed to bereavement by a violent method. […] Conversely, PGD is less common in cases where the bereaved death was due to natural disasters. […] PGD has higher prevalence in women. […] A 2021 meta-analysis identified a global prevalence of 14.2% in prolonged grief disorders among bereaved families dealing with cancer-related deaths.

• #13 Treating complicated grief | Open Arms

  https://www.openarms.gov.au/health-professionals/assessment-and-treatment/treating-complicated-grief

  Approximately one in ten bereaved people experience complicated grief, with higher rates amongst those bereaved by disaster or violent death, or parents who lose a child. […] Approximately 10% of bereaved people experience complicated grief. […] Higher rates exist amongst those bereaved by disaster or violent death, or parents who lose a child (Shear et al., 2011).

• #14 Complicated Grief: What is it & How to Cope | Aetna

  https://www.aetna.com/health-guide/complicated-grief.html

  Feeling sad, depressed, or anxious after the death of a loved one is normal, according to psychiatrist Katherine Shear, MD, director of the Center for Complicated Grief at Columbia University. But for people who experience complicated grief, the initial intensity of these feelings doesnt fade over time and ultimately robs them of the ability to engage in and enjoy life. […] Complicated grief affects around 7 percent of people who have lost a loved one, or more than 10 million people in the U.S. alone, according to estimates from the Center for Complicated Grief. Though it can affect anyone, people with a history of anxiety or depression or who have lost someone in a sudden, violent way may be more prone. Additionally, losing a partner doubles your risk of complicated grief; when a child dies, its even higher.

• #15 Complicated Grief | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/complicated-grief/

  Complicated grief affects between 2% to 3% of the population worldwide and 7% to 10% of bereaved people. […] This condition is characterized by intense grief that lasts longer than would be normally expected and that impairs daily functioning. […] Complicated grief can follow the loss of any close relationship, especially after the death of a romantic partner and among parents who have lost a child. […] Risk factors include a history of mood or anxiety disorders, alcohol or drug abuse, and multiple losses. […] Depression in persons who have been caregivers during a loved one’s terminal illness and those who had depression early in bereavement are more likely to develop complicated grief later in bereavement. […] There are two approaches: one deals with complicated grief; the other gives us strategies for accepting the loss and for restoring a sense of the possibility of future happiness.

• #16 Complicated Grief: Coping with a Pain That Doesn’t End

  https://www.betterup.com/blog/complicated-grief

  Anxiety. People suffering from an anxiety disorder are more likely to experience complicated grief after the loss of a loved one. […] Mental health conditions. Those who already have mental health disorders such as depression can develop complicated grief. […] If left untreated, complicated grief can also lead to alcohol or substance abuse.

• #17 Complicated Grief: Coping with a Pain That Doesn’t End

  https://www.betterup.com/blog/complicated-grief

  Complicated grief is a prolonged grief disorder that prevents a bereaved person from overcoming a loved ones death. […] Complicated grief is most often caused by an unexpected or sudden death of a loved one, especially the death of a close family member, child, or friend. […] The prevalence of complicated grief is in only about 7% of bereaved people. […] Studies show that complicated grief activates different parts of the brain. […] The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) sets a working complicated grief definition. […] They also noted that complicated or prolonged grief is a disorder that requires further study. […] There are several risk factors and complications that occur: Childhood trauma. People who have had traumatic childhood experiences tend to be more prone to complicated grief.

• #18 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Prevalence estimates in non-Westernized populations living in non-Western countries appear to be somewhat lower than in refugee populations, although still relatively high. […] Previous studies identified several factors present before, during, and after the loss, or related to the loss that increased or decreased the risk for PGD development. […] However, there are indications of important cross-cultural discrepancies between Westernized and non-Westernized countries that define the specific risk for PGD, as some factors may not be applicable across different cultures or could be attributable to racial and socioeconomic inequalities. […] The lack of social support after a loss has been identified as a risk factor for the development of PGD. […] The present paper reviewed grief reactions and symptoms across cultures, the prevalence estimates, and risk factors for PGD across countries and regions of the globe that may impact PGD on the global stage.

• #19 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  In a 2024 systematic review, Taiwanese family members who were involved in mostly cancer caregiving, could be at risk for PGD if they felt ill-prepared for the relative’s death. […] Two review articles based in Europe indicated that abnormal grief could be linked to decreased levels of preparedness for a family member’s death. […] There exists conflicting evidence on whether PGD is more or less common in eastern countries compared to western countries. […] However, according to a meta-analysis conducted in 2024, which pooled prevalence rates among five studies from China and Japan, the prevalence rate of prolonged grief disorder was found to be 8.9%.

• #20 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  The nature of the relationship to the deceased, personality traits, coping style, psychiatric history and comorbidities, and socioeconomic factors all contribute to the risk of CG. […] Studies conducted by Mancini et al. (2015) and Schenck et al. (2015) concluded that individuals with insecure attachment styles remained more focused on negative cognitions about the deceased than those with secure attachment styles. […] Findings also revealed a higher level of CG symptoms among bereaved individuals with insecure attachment styles. […] Although significant symptom overlap exists whether CG is primary or secondary to PTSD, each disorder has its own unique features. […] Common comorbidities and similar symptom overlap between CG and other mental health disorders add to the challenge of identifying optimal treatments.

• #21 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  PGD is estimated to be experienced by about 10 percent of bereaved survivors, although rates vary substantially depending on populations sampled and definitions used. […] According to a 2017 meta-analysis, prevalence of prolonged grief is estimated to be 9.8%, although higher prevalence estimates, as high as 49%, are possible if the death was not due to natural causes. […] PGD is also more prevalent when the death is by a violent method such as homicide or suicide, with an estimated 70% of those with PGD in the study having been exposed to bereavement by a violent method. […] Conversely, PGD is less common in cases where the bereaved death was due to natural disasters. […] PGD has higher prevalence in women. […] A 2021 meta-analysis identified a global prevalence of 14.2% in prolonged grief disorders among bereaved families dealing with cancer-related deaths.

• #22 Complicated grief – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374

  For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. […] If you’re unable to move through these stages more than a year after the death of a loved one, you may have complicated grief. […] Contact your doctor or a mental health professional if you have intense grief and problems functioning that don’t improve at least one year after the passing of your loved one. […] Complicated grief occurs more often in females and with older age. […] Complicated grief can affect you physically, mentally and socially. Without appropriate treatment, complications may include: […] It’s not clear how to prevent complicated grief. Getting counseling soon after a loss may help, especially for people at increased risk of developing complicated grief.

• #23 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This disorder is increasingly recognized as a distinct mental health concern, particularly when symptoms such as longing, emotional numbness, and identity disruption persist for more than a year. […] Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] Results from studies evaluating sex differences in prolonged grief show mixed results, with some showing little difference.

• #24 Complicated Grief: Symptoms, Diagnosis, Treatment

  https://www.verywellmind.com/complicated-grief-symptoms-diagnosis-and-treatment-5089396

  Complicated grief, also known as prolonged grief disorder, is a condition that can occur in some people who have just lost a loved one or are experiencing grief for another reason. It is characterized by feelings of intense grief that last a year or longer and interfere with the healing process. […] About 7% to 10% of bereaved people might experience complicated grief. […] Complicated grief itself is not a recognized mental health condition. However, in the latest edition of the „Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR), a new condition called prolonged grief disorder was added. […] Complicated grief has also proven to be more prevalent in older individuals. One study found that around 9% of older women experience complicated grief.

• #25 Complicated grief – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374

  For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. […] If you’re unable to move through these stages more than a year after the death of a loved one, you may have complicated grief. […] Contact your doctor or a mental health professional if you have intense grief and problems functioning that don’t improve at least one year after the passing of your loved one. […] Complicated grief occurs more often in females and with older age. […] Complicated grief can affect you physically, mentally and socially. Without appropriate treatment, complications may include: […] It’s not clear how to prevent complicated grief. Getting counseling soon after a loss may help, especially for people at increased risk of developing complicated grief.

• #26 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  Every day, millions of Americans grieve the death of a loved one. Some bereaved individuals will find their grief so emotionally intense that it persists an unusually long time, causes various problems and interferes with daily life. As of March 2022, the American Psychiatric Association now calls this Prolonged Grief Disorder (PGD). […] PGD is associated with major public health concerns, such as increased suicidality and suicidal thinking, risk for cardiovascular health, and substance misuse for bereaved individuals. […] PGD may also have disproportionate effects on communities of color, with studies showing Black individuals reporting more severe maladaptive grief reactions compared to white individuals due to the increased exposure to homicide among Black individuals and communities.

• #27 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  In a 2024 systematic review, Taiwanese family members who were involved in mostly cancer caregiving, could be at risk for PGD if they felt ill-prepared for the relative’s death. […] Two review articles based in Europe indicated that abnormal grief could be linked to decreased levels of preparedness for a family member’s death. […] There exists conflicting evidence on whether PGD is more or less common in eastern countries compared to western countries. […] However, according to a meta-analysis conducted in 2024, which pooled prevalence rates among five studies from China and Japan, the prevalence rate of prolonged grief disorder was found to be 8.9%.

• #28 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  Additionally, losing a loved one during the COVID-19 pandemic is a risk factor for PGD, with communities of color potentially being at higher risk due to racial disparities in COVID-19 deaths. […] One of these factors was COVID-19, with many bereavement experts believing that the unprecedented amount of deaths from COVID-19 would lead to an increase in incidences of PGD making PGD a major public health concern. […] Approximately 10% of bereaved children and adults experience PGD and its symptoms, although almost no studies have examined the incidence or prevalence rates of PGD in youth, which can manifest differently than in adults. […] PGD is characterized by intense and persistent grief reactions that can become maladaptive if these reactions cause impairment to daily life, as well as hinder a bereaved individual’s ability to be able to successfully cope with their grief in a healthy way.

• #29 Prolonged grief disorder is now in the DSM. Here’s what you need to know. – The Washington Post

  https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/

  With the United States surpassing 727,000 deaths from covid-19, the disease caused by the coronavirus, millions have been left grieving the losses of their loved ones. […] “In the current environment, we are likely to see more people whose grief doesn’t lessen with time, and whose intense suffering disrupts their ability to function,” said Holly G. Prigerson, professor of sociology in medicine at Weill Cornell Medicine in New York City and a co-author of “Bereavement: Studies of Grief in Adult Life.” […] The American Psychiatric Association recently announced that prolonged grief disorder (PGD) will be added to the newest version of the manual, DSM-5-TR. […] “But for a small but significant group of people, grief doesn’t resolve. It is ongoing, pervasive, intense and debilitating,” said Katherine Shear, professor of psychiatry at the School of Social Work and founding director of the Center for Complicated Grief at Columbia University. “This is what we call prolonged grief disorder.”

• #30 Coping With Complicated Grief | Cedars-Sinai

  https://www.cedars-sinai.org/blog/understanding-prolonged-grief-disorder.html

  „Prolonged or complicated grief, on the other hand, occurs when a person’s initial pain continues at the same level every day, swallowing the rest of their life, Dr. Danovitch explains.” […] „In PGD, emotional distress remains overwhelming 12 months after a loved one’s death for adults, or six months for children and teens, according to the APA.” […] „Certain factors increase the risk of complicated grief.” […] „The disruption of traditional mourning rituals during the COVID-19 pandemic, such as limitations on family and faith gatherings, made connecting and processing loss harder, Dr. Danovitch says.” […] „While other mental health conditions might mimic prolonged grief disorder, Dr. Danovitch points out that it’s a distinct diagnosis with its own symptoms and criteria.” […] „Complicated grief therapy, specifically tailored to maladaptive grief.” […] „Therapists can help grievers work through memories of the person and develop healthier ways to remember them and reflect, Dr. Danovitch notes.”

• #31 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  Additionally, losing a loved one during the COVID-19 pandemic is a risk factor for PGD, with communities of color potentially being at higher risk due to racial disparities in COVID-19 deaths. […] One of these factors was COVID-19, with many bereavement experts believing that the unprecedented amount of deaths from COVID-19 would lead to an increase in incidences of PGD making PGD a major public health concern. […] Approximately 10% of bereaved children and adults experience PGD and its symptoms, although almost no studies have examined the incidence or prevalence rates of PGD in youth, which can manifest differently than in adults. […] PGD is characterized by intense and persistent grief reactions that can become maladaptive if these reactions cause impairment to daily life, as well as hinder a bereaved individual’s ability to be able to successfully cope with their grief in a healthy way.

• #32 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  In older adults, prolonged grief can affect as many as a quarter of those suffering a loss, according to a 2011 study, while a 2014 study in JAMA Psychiatry stated that about 9 percent of bereaved older women, defined as women over the age of 65, experience prolonged grief. […] After this pandemic, rates of prolonged grief among older adults may move even higher, says Simon, but given the DSM-5s requirement that grief persist for twelve months following a loss, not enough time has elapsed for data to be assessed. […] Yet, caregivers like Simon are preparing. A June 2020 letter in Psychiatry Research issued an early warning that increased rates of prolonged grief may be expected considering the circumstances of many COVID-19 deaths in which symptoms of prolonged grief are typically elevated when deaths are unexpected, traditional grief rituals (e.g., saying goodbye, viewing, and burial of the body) are absent, and physical social support is lacking.

• #33 A population study of prolonged grief in refugees | Epidemiology and Psychiatric Sciences | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/population-study-of-prolonged-grief-in-refugees/A913E43B81990D959B8133916B97F4FD

  Aims: Despite the frequency that refugees suffer bereavement, there is a dearth of research into the prevalence and predictors of problematic grief reactions in refugees. To address this gap, this study reports a nationally representative population-based study of refugees to determine the prevalence of probable prolonged grief disorder (PGD) and its associated problems. […] Probable PGD was associated with a greater likelihood of mental illness, probable PTSD, severe mental illness, currently unemployed and reported disability. […] Probable PGD was also associated with the history of imprisonment, torture and separation from family. […] The low rate of access to mental health assistance for these refugees highlights that there is a need to address this issue in refugee populations. […] Rates of probable PGD in refugees have varied between 8 and 54%, but these have been in small, clinical or non-representative studies. Accordingly, these rates do not provide accurate estimates of the occurrence of PGD in refugees.

• #34 A population study of prolonged grief in refugees | Epidemiology and Psychiatric Sciences | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/population-study-of-prolonged-grief-in-refugees/A913E43B81990D959B8133916B97F4FD

  The goal of this study was to conduct a population-based study of refugees to determine the prevalence, predictors and costs of probable PGD in a large, nationally representative sample of refugees. […] The presence of probable PGD was strongly associated with psychological comorbidity and impairment, including PTSD, severe mental illness, reported disability, not being employed and difficulty trusting others in the community. […] The likelihood of developing probable PGD was significantly heightened by exposure to a wide range of trauma and non-traumatic stressors. […] A significant proportion of refugees do not seek assistance for their PGD, and this points to the need for removing barriers to accessing appropriate care.

• #35 A population study of prolonged grief in refugees | Epidemiology and Psychiatric Sciences | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/population-study-of-prolonged-grief-in-refugees/A913E43B81990D959B8133916B97F4FD

  Aims: Despite the frequency that refugees suffer bereavement, there is a dearth of research into the prevalence and predictors of problematic grief reactions in refugees. To address this gap, this study reports a nationally representative population-based study of refugees to determine the prevalence of probable prolonged grief disorder (PGD) and its associated problems. […] Probable PGD was associated with a greater likelihood of mental illness, probable PTSD, severe mental illness, currently unemployed and reported disability. […] Probable PGD was also associated with the history of imprisonment, torture and separation from family. […] The low rate of access to mental health assistance for these refugees highlights that there is a need to address this issue in refugee populations. […] Rates of probable PGD in refugees have varied between 8 and 54%, but these have been in small, clinical or non-representative studies. Accordingly, these rates do not provide accurate estimates of the occurrence of PGD in refugees.

• #36 Complicated grief following the perinatal loss: a systematic review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06986-y

  Kersting and Wagner found that 25-30% of parents experience CG following perinatal loss. It is characterized by persistent, distressing, and debilitating symptoms, leading to physical, psychosocial, emotional, and cognitive changes. […] Overall, according to the findings, a significant proportion of parents with perinatal loss have experienced CG. However, the symptoms of CG following perinatal loss and its influencing factors remain unclear. […] This systematic review found that perinatal loss of CG results from multiple interacting factors, including demographic characteristics, reproductive characteristics, marital relationships, social support, and coping strategies. […] A growing body of evidence supports the hypothesis that people with perinatal loss are at risk of experiencing CG. Importantly, it is considered to be a clinically relevant disorder. CG, which prevents a person from returning to pre-social functioning, has been linked to psychological disorders and an increased risk of death.

• #37 Complicated grief | Cruse Bereavement Support

  https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/

  Over time most people start to adapt and feel better after someone dies. When someone becomes stuck or is still unable to cope after many months it is sometimes known as complicated grief or prolonged grief disorder. […] Our understanding of complicated grief or prolonged grief disorder is still growing. The terms are often used interchangeably and in the UK people are not usually given them as a diagnosis by a doctor. […] Prolonged grief disorder or complicated grief is when intense, long-lasting symptoms of grief, together with ongoing problems and difficulties in coping with life, go on for more than six months after someone dies. […] There’s still a lot more to learn about complicated grief, but the following things are risk factors: […] If your child has died you may be more likely to experience complicated or prolonged grief. […] If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce.

• #38 Complicated grief following the perinatal loss: a systematic review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06986-y

  Kersting and Wagner found that 25-30% of parents experience CG following perinatal loss. It is characterized by persistent, distressing, and debilitating symptoms, leading to physical, psychosocial, emotional, and cognitive changes. […] Overall, according to the findings, a significant proportion of parents with perinatal loss have experienced CG. However, the symptoms of CG following perinatal loss and its influencing factors remain unclear. […] This systematic review found that perinatal loss of CG results from multiple interacting factors, including demographic characteristics, reproductive characteristics, marital relationships, social support, and coping strategies. […] A growing body of evidence supports the hypothesis that people with perinatal loss are at risk of experiencing CG. Importantly, it is considered to be a clinically relevant disorder. CG, which prevents a person from returning to pre-social functioning, has been linked to psychological disorders and an increased risk of death.

• #39 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  PGD is estimated to be experienced by about 10 percent of bereaved survivors, although rates vary substantially depending on populations sampled and definitions used. […] According to a 2017 meta-analysis, prevalence of prolonged grief is estimated to be 9.8%, although higher prevalence estimates, as high as 49%, are possible if the death was not due to natural causes. […] PGD is also more prevalent when the death is by a violent method such as homicide or suicide, with an estimated 70% of those with PGD in the study having been exposed to bereavement by a violent method. […] Conversely, PGD is less common in cases where the bereaved death was due to natural disasters. […] PGD has higher prevalence in women. […] A 2021 meta-analysis identified a global prevalence of 14.2% in prolonged grief disorders among bereaved families dealing with cancer-related deaths.

• #40 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Complicated grief (CG) may occur because of the trauma associated with family caregivers perceptions of their loved ones suffering, either from advanced cancer or from side effects of cancer treatment. […] CG may occur in as many as 40% of family caregivers who lose a close family member to cancer. […] CG disproportionately affects older adults, with more than 25% of older adults experiencing CG, compared to only 5%7% of the general population. […] CG is associated with numerous psychological problems, including loneliness, social isolation, anxiety, clinical depression, cognitive impairment, and post-traumatic stress disorder (PTSD). […] Compounded losses of multiple close family members and friends, increased likelihood that the deceased will be a spouse or partner, and financial burdens associated with the loss may lead to a higher incidence of CG among older adults.

• #41 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Complicated grief (CG) may occur because of the trauma associated with family caregivers perceptions of their loved ones suffering, either from advanced cancer or from side effects of cancer treatment. […] CG may occur in as many as 40% of family caregivers who lose a close family member to cancer. […] CG disproportionately affects older adults, with more than 25% of older adults experiencing CG, compared to only 5%7% of the general population. […] CG is associated with numerous psychological problems, including loneliness, social isolation, anxiety, clinical depression, cognitive impairment, and post-traumatic stress disorder (PTSD). […] Compounded losses of multiple close family members and friends, increased likelihood that the deceased will be a spouse or partner, and financial burdens associated with the loss may lead to a higher incidence of CG among older adults.

• #42 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Complicated grief (CG) may occur because of the trauma associated with family caregivers perceptions of their loved ones suffering, either from advanced cancer or from side effects of cancer treatment. […] CG may occur in as many as 40% of family caregivers who lose a close family member to cancer. […] CG disproportionately affects older adults, with more than 25% of older adults experiencing CG, compared to only 5%7% of the general population. […] CG is associated with numerous psychological problems, including loneliness, social isolation, anxiety, clinical depression, cognitive impairment, and post-traumatic stress disorder (PTSD). […] Compounded losses of multiple close family members and friends, increased likelihood that the deceased will be a spouse or partner, and financial burdens associated with the loss may lead to a higher incidence of CG among older adults.

• #43 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  In a 2024 systematic review, Taiwanese family members who were involved in mostly cancer caregiving, could be at risk for PGD if they felt ill-prepared for the relative’s death. […] Two review articles based in Europe indicated that abnormal grief could be linked to decreased levels of preparedness for a family member’s death. […] There exists conflicting evidence on whether PGD is more or less common in eastern countries compared to western countries. […] However, according to a meta-analysis conducted in 2024, which pooled prevalence rates among five studies from China and Japan, the prevalence rate of prolonged grief disorder was found to be 8.9%.

• #44 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. […] Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost. […] There are many public health benefits now that PGD is in the DSM-5-TR. Insurance companies can now cover the cost of treatment for bereaved individuals diagnosed with PGD. Mental health clinicians would be more knowledgeable and now have a better understanding of grief. […] Additionally, there is now greater public awareness and recognition of PGD as a public health issue.

• #45 Complicated grief – GPMHSC

  https://gpmhsc.org.au/guidelines/index/1998aae6-2bdc-4647-8820-7becb21bf3db

  Complicated grief is associated with substantial impairment in work, health and social functioning. […] About 10% of bereaved people experience complicated grief (also referred to as prolonged grief disorder and persistent complex bereavement-related disorder). This is a syndrome of prolonged (ie well beyond six months) or intense grief, resulting from a failure to transition from acute to integrated grief. Complicated grief is associated with substantial impairment in work, health and social functioning. […] People with complicated grief are at increased risk for cardiac disease, cancer, hypertension, substance-use disorders and suicidality. […] Several assessment instruments have been developed to screen and diagnose people with complicated grief. The Inventory of Complicated Grief is the instrument that has been most commonly used to identify complicated grief symptoms in research. […] Standard grief-focused supportive psychotherapies and psychotropic medications such as antidepressants do not appear to be effective for complicated grief. However, targeted complicated grief treatment has shown significant benefit.

• #46 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. […] Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost. […] There are many public health benefits now that PGD is in the DSM-5-TR. Insurance companies can now cover the cost of treatment for bereaved individuals diagnosed with PGD. Mental health clinicians would be more knowledgeable and now have a better understanding of grief. […] Additionally, there is now greater public awareness and recognition of PGD as a public health issue.

• #47 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  Background The majority of individuals experience normal grief after the death of a loved one (see Fast Fact #32). However, about 10-20% of bereaved individuals experience a persistent, debilitating phenomenon referred to as complicated grief (CG) (1). Complicated grief has also been referred to as prolonged or pathologic grief (2); and in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), CG was relabeled as Persistent Complex Bereavement Disorder (3). […] CG is associated with mental and physical health problems including depression, hypertension, work and social impairment and reduced quality of life. Additionally, CG increases an individual’s risk of suicide and suicidal behavior (7). […] Most bereaved individuals experience normal grief. A minority will experience long-term, persistent, disruptive symptoms that impair functioning and increase the risk for negative mental and physical health states. Individuals suffering from CG benefit from referral to a trained mental health provider who can administer therapy specific to CG.

• #48 What is complicated grief? Symptoms and treatment

  https://www.medicalnewstoday.com/articles/complicated-grief

  A therapist can diagnose prolonged grief based on someones symptoms. […] Some therapists specialize in grief therapy. […] There is also a specific form of talk therapy for complicated grief, known as complicated grief treatment. […] A 2021 systematic review and meta-analysis of 23 prior studies on grief found a 63% co-occurrence rate for depression.

• #49 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Complicated grief (CG) may occur because of the trauma associated with family caregivers perceptions of their loved ones suffering, either from advanced cancer or from side effects of cancer treatment. […] CG may occur in as many as 40% of family caregivers who lose a close family member to cancer. […] CG disproportionately affects older adults, with more than 25% of older adults experiencing CG, compared to only 5%7% of the general population. […] CG is associated with numerous psychological problems, including loneliness, social isolation, anxiety, clinical depression, cognitive impairment, and post-traumatic stress disorder (PTSD). […] Compounded losses of multiple close family members and friends, increased likelihood that the deceased will be a spouse or partner, and financial burdens associated with the loss may lead to a higher incidence of CG among older adults.

• #50 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief affects an estimated 7% of all adults who experience grief. […] Complicated grief or prolonged grief disorder is a relatively new addition to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), so research is ongoing to learn more about it. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] Treatment for complicated grief is possible through therapy and support groups.

• #51 Fire Fighter Death: The Difference Between Normal Grief and Complicated Grief | IAFF Recovery Center

  https://www.iaffrecoverycenter.com/blog/the-difference-between-normal-grief-and-complicated-grief

  Certain factors can put individuals at particularly high risk of complicated grief. These include: Lack of familial or social support, Death of a spouse or child, History of mental health struggles, Grief associated with a violent or traumatic death. […] But when complicated grief begins to take hold, its important to seek help sooner rather than later. Early intervention can help individuals work through loss, and learn how to live fulfilling, meaningful lives despite personal tragedy. […] If left untreated, complicated grief can transform into other problems, including depression and addiction.

• #52 Complicated Grief: Coping with a Pain That Doesn’t End

  https://www.betterup.com/blog/complicated-grief

  Anxiety. People suffering from an anxiety disorder are more likely to experience complicated grief after the loss of a loved one. […] Mental health conditions. Those who already have mental health disorders such as depression can develop complicated grief. […] If left untreated, complicated grief can also lead to alcohol or substance abuse.

• #53 Prolonged grief disorder is now in the DSM. Here’s what you need to know. – The Washington Post

  https://www.washingtonpost.com/lifestyle/2021/10/21/prolonged-grief-disorder-diagnosis-dsm-5/

  PGD puts people at higher risk for medical problems (cancer, high blood pressure, heart or immunological issues), other mental health disorders, disability, hospitalization and suicide. […] Research has identified several factors that complicate grief. […] “Sudden and traumatic deaths, and deaths by suicide, are more likely to lead to complicated grief,” Skritskaya said. […] Treatments for complicated grief have been investigated since the late 1990s and practiced for much longer. […] “Research showed that neither antidepressants nor standard depression-focused therapy are very effective for complicated grief,” Shear said. […] A 2014 Australian study found that grief-focused cognitive behavior therapy helped those with PGD. […] While psychotherapy is a first-line treatment for PGD, antidepressants can be helpful with the depression that often accompanies complicated grief.

• #54 Dr. Prigerson Highlighted in New York Times Article on Prolonged Grief Disorder (PGD) | Weill Department of Medicine

  https://medicine.weill.cornell.edu/news/dr-prigerson-highlighted-new-york-times-article-prolonged-grief-disorder-pgd

  PGD, which was previously considered a complicated grief and persistent complex bereavement disorder requiring further study, has recently been listed as a condition in the Diagnostic and Statistical Manual of Mental Disorders. […] Today, it is understood that PGD is a syndrome in which people feel stuck in a cycle of mourning that can last for years or even decades. […] It is normal to experience a myriad of feelings during an acute phase of grief after experiencing the death of a loved one, but when some of those feelings continue every day for an extended period of time, grief counselors consider it to be a worrisome sign of PGD. […] This is of special significance in light of PGD being associated with a greater risk for sleep disorders, depression, drug and alcohol abuse, hospitalization, and suicide attempts.

• #55 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  Every day, millions of Americans grieve the death of a loved one. Some bereaved individuals will find their grief so emotionally intense that it persists an unusually long time, causes various problems and interferes with daily life. As of March 2022, the American Psychiatric Association now calls this Prolonged Grief Disorder (PGD). […] PGD is associated with major public health concerns, such as increased suicidality and suicidal thinking, risk for cardiovascular health, and substance misuse for bereaved individuals. […] PGD may also have disproportionate effects on communities of color, with studies showing Black individuals reporting more severe maladaptive grief reactions compared to white individuals due to the increased exposure to homicide among Black individuals and communities.

• #56 Complicated grief – GPMHSC

  https://gpmhsc.org.au/guidelines/index/1998aae6-2bdc-4647-8820-7becb21bf3db

  Complicated grief is associated with substantial impairment in work, health and social functioning. […] About 10% of bereaved people experience complicated grief (also referred to as prolonged grief disorder and persistent complex bereavement-related disorder). This is a syndrome of prolonged (ie well beyond six months) or intense grief, resulting from a failure to transition from acute to integrated grief. Complicated grief is associated with substantial impairment in work, health and social functioning. […] People with complicated grief are at increased risk for cardiac disease, cancer, hypertension, substance-use disorders and suicidality. […] Several assessment instruments have been developed to screen and diagnose people with complicated grief. The Inventory of Complicated Grief is the instrument that has been most commonly used to identify complicated grief symptoms in research. […] Standard grief-focused supportive psychotherapies and psychotropic medications such as antidepressants do not appear to be effective for complicated grief. However, targeted complicated grief treatment has shown significant benefit.

• #57 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief affects an estimated 7% of all adults who experience grief. […] Complicated grief or prolonged grief disorder is a relatively new addition to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), so research is ongoing to learn more about it. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] Treatment for complicated grief is possible through therapy and support groups.

• #58 The difficult case of complicated grief and the role of phenomenology in psychiatry

  https://journals.openedition.org/phenomenology/1334

  It has been argued that some unremitting forms of grief, commonly labeled as complicated grief, pose a serious threat to the well-being and life of the mourner and may require clinical attention (Lichtenthal et al., 2004; Zisook et al., 2010). […] Complicated grief (CG) is a commonly used term to describe the latter (Zisook Shear, 2009). The need for diagnostic criteria for CG has been recognized in recent and forthcoming editions of diagnostic manuals that provide operationalized criteria for mental disorders (DSM-5; ICD-11 Beta draft). […] Complicated grief is indicated by the score equal or higher than 30 at the time of six months after the loss. Several studies suggest that the score qualifying for CG on that scale is correlated with impairment and negative health consequences, such as: sleep disturbances (Hardison et al., 2005); daily routine disruptions (Monk et al., 2006); increased risk for cancer, cardiac disease, substance abuse and suicidality (Prigerson et al., 1999; Szanto et al., 2006).

• #59 The difficult case of complicated grief and the role of phenomenology in psychiatry

  https://journals.openedition.org/phenomenology/1334

  It has been argued that some unremitting forms of grief, commonly labeled as complicated grief, pose a serious threat to the well-being and life of the mourner and may require clinical attention (Lichtenthal et al., 2004; Zisook et al., 2010). […] Complicated grief (CG) is a commonly used term to describe the latter (Zisook Shear, 2009). The need for diagnostic criteria for CG has been recognized in recent and forthcoming editions of diagnostic manuals that provide operationalized criteria for mental disorders (DSM-5; ICD-11 Beta draft). […] Complicated grief is indicated by the score equal or higher than 30 at the time of six months after the loss. Several studies suggest that the score qualifying for CG on that scale is correlated with impairment and negative health consequences, such as: sleep disturbances (Hardison et al., 2005); daily routine disruptions (Monk et al., 2006); increased risk for cancer, cardiac disease, substance abuse and suicidality (Prigerson et al., 1999; Szanto et al., 2006).

• #60 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief affects an estimated 7% of all adults who experience grief. […] Complicated grief or prolonged grief disorder is a relatively new addition to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), so research is ongoing to learn more about it. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] Treatment for complicated grief is possible through therapy and support groups.

• #61 Complicated grief – GPMHSC

  https://gpmhsc.org.au/guidelines/index/1998aae6-2bdc-4647-8820-7becb21bf3db

  Complicated grief is associated with substantial impairment in work, health and social functioning. […] About 10% of bereaved people experience complicated grief (also referred to as prolonged grief disorder and persistent complex bereavement-related disorder). This is a syndrome of prolonged (ie well beyond six months) or intense grief, resulting from a failure to transition from acute to integrated grief. Complicated grief is associated with substantial impairment in work, health and social functioning. […] People with complicated grief are at increased risk for cardiac disease, cancer, hypertension, substance-use disorders and suicidality. […] Several assessment instruments have been developed to screen and diagnose people with complicated grief. The Inventory of Complicated Grief is the instrument that has been most commonly used to identify complicated grief symptoms in research. […] Standard grief-focused supportive psychotherapies and psychotropic medications such as antidepressants do not appear to be effective for complicated grief. However, targeted complicated grief treatment has shown significant benefit.

• #62 Complicated grief – GPMHSC

  https://gpmhsc.org.au/guidelines/index/1998aae6-2bdc-4647-8820-7becb21bf3db

  Complicated grief is associated with substantial impairment in work, health and social functioning. […] About 10% of bereaved people experience complicated grief (also referred to as prolonged grief disorder and persistent complex bereavement-related disorder). This is a syndrome of prolonged (ie well beyond six months) or intense grief, resulting from a failure to transition from acute to integrated grief. Complicated grief is associated with substantial impairment in work, health and social functioning. […] People with complicated grief are at increased risk for cardiac disease, cancer, hypertension, substance-use disorders and suicidality. […] Several assessment instruments have been developed to screen and diagnose people with complicated grief. The Inventory of Complicated Grief is the instrument that has been most commonly used to identify complicated grief symptoms in research. […] Standard grief-focused supportive psychotherapies and psychotropic medications such as antidepressants do not appear to be effective for complicated grief. However, targeted complicated grief treatment has shown significant benefit.

• #63 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  Background The majority of individuals experience normal grief after the death of a loved one (see Fast Fact #32). However, about 10-20% of bereaved individuals experience a persistent, debilitating phenomenon referred to as complicated grief (CG) (1). Complicated grief has also been referred to as prolonged or pathologic grief (2); and in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), CG was relabeled as Persistent Complex Bereavement Disorder (3). […] CG is associated with mental and physical health problems including depression, hypertension, work and social impairment and reduced quality of life. Additionally, CG increases an individual’s risk of suicide and suicidal behavior (7). […] Most bereaved individuals experience normal grief. A minority will experience long-term, persistent, disruptive symptoms that impair functioning and increase the risk for negative mental and physical health states. Individuals suffering from CG benefit from referral to a trained mental health provider who can administer therapy specific to CG.

• #64 A population study of prolonged grief in refugees | Epidemiology and Psychiatric Sciences | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/population-study-of-prolonged-grief-in-refugees/A913E43B81990D959B8133916B97F4FD

  Aims: Despite the frequency that refugees suffer bereavement, there is a dearth of research into the prevalence and predictors of problematic grief reactions in refugees. To address this gap, this study reports a nationally representative population-based study of refugees to determine the prevalence of probable prolonged grief disorder (PGD) and its associated problems. […] Probable PGD was associated with a greater likelihood of mental illness, probable PTSD, severe mental illness, currently unemployed and reported disability. […] Probable PGD was also associated with the history of imprisonment, torture and separation from family. […] The low rate of access to mental health assistance for these refugees highlights that there is a need to address this issue in refugee populations. […] Rates of probable PGD in refugees have varied between 8 and 54%, but these have been in small, clinical or non-representative studies. Accordingly, these rates do not provide accurate estimates of the occurrence of PGD in refugees.

• #65 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Complicated grief (CG) may occur because of the trauma associated with family caregivers perceptions of their loved ones suffering, either from advanced cancer or from side effects of cancer treatment. […] CG may occur in as many as 40% of family caregivers who lose a close family member to cancer. […] CG disproportionately affects older adults, with more than 25% of older adults experiencing CG, compared to only 5%7% of the general population. […] CG is associated with numerous psychological problems, including loneliness, social isolation, anxiety, clinical depression, cognitive impairment, and post-traumatic stress disorder (PTSD). […] Compounded losses of multiple close family members and friends, increased likelihood that the deceased will be a spouse or partner, and financial burdens associated with the loss may lead to a higher incidence of CG among older adults.

• #66 Complicated grief following the perinatal loss: a systematic review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06986-y

  Perinatal loss is a severe stressor that usually triggers distressing symptoms of acute grief. Moreover, acute grief can worsen with time and become a chronic debilitating state known as complicated grief. However, there is a lack of comprehensive reviews on this topic. This systematic review aims to synthesize the existing literature on complicated grief following the perinatal loss. […] Individuals may experience complicated grief following perinatal loss, manifesting in symptoms such as emotional reactions, physical responses, and social impairments. Furthermore, based on existing evidence, influencing factors include demographic characteristics, reproductive characteristics, marital relationships, social support, and coping strategies. […] Complicated grief following perinatal loss is easily overlooked and has not been adequately studied. Further empirical research is needed to explore the symptoms and factors influencing this condition. A better understanding of complicated grief will help develop and optimize care strategies, informing future clinical practice and improving psychological support for individuals affected by perinatal loss.

• #67

  https://link.springer.com/article/10.1007/s00127-023-02469-1

  Results demonstrated that common features of PGD in the UK population (at the moderate and strict level) include longing and preoccupation with the deceased, intense sadness, and loss of identity. […] These findings suggested that the prevalence of ICD-11 PGD was between 2.4 and 8%. […] The variability in prevalence rates and risk factors when using the moderate and strict diagnostic algorithms emphasizes the need for an agreed upon expert consensus as to which algorithm to carry forward.

• #68 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  Background The majority of individuals experience normal grief after the death of a loved one (see Fast Fact #32). However, about 10-20% of bereaved individuals experience a persistent, debilitating phenomenon referred to as complicated grief (CG) (1). Complicated grief has also been referred to as prolonged or pathologic grief (2); and in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), CG was relabeled as Persistent Complex Bereavement Disorder (3). […] CG is associated with mental and physical health problems including depression, hypertension, work and social impairment and reduced quality of life. Additionally, CG increases an individual’s risk of suicide and suicidal behavior (7). […] Most bereaved individuals experience normal grief. A minority will experience long-term, persistent, disruptive symptoms that impair functioning and increase the risk for negative mental and physical health states. Individuals suffering from CG benefit from referral to a trained mental health provider who can administer therapy specific to CG.

• #69 Epidemiology of Prolonged Grief Disorder – 1 CE Hour – Center for Prolonged Grief

  https://prolongedgrief.columbia.edu/product/pgd-epidemiology/

  Prolonged Grief Disorder (PGD) is now included in the DSM-5-TR and the ICD-11, making it possible to expand the knowledge base of its basic epidemiology to global populations. This presentation will describe the social determinants, occurrence, and distribution of PGD based on what we know so far. […] It will also discuss the prevalence of bereavement and its relationship with disadvantage, highlighting a social justice perspective. […] Describe the prevalence of PGD. […] Describe the association between bereavement, disadvantage, and social justice.

• #70 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Prevalence estimates for PGD appear to be quite similar across Western and non-Western countries, with the apparent higher rates in non-Western countries at least partially explained by confounding factors including the specificities of the specific populations studied. […] Overall, the existing literature supports that about 10% of individuals have been shown to go on developing PGD after the loss of a loved one. […] Therefore, no globally applicable criteria set exists yet. […] Validating and/or developing screening and assessment measures that are reliable across cultures is critical to support future cross-cultural research on grief reactions and PGD. […] The International Prolonged Grief Disorder Scale assesses PGD for the ICD-11 and includes a cultural supplement that offers information on culturally-relevant grief symptoms.

• #71 Complicated grief – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/diagnosis-treatment/drc-20360389

  Grieving is a highly individual process for each person, and determining when normal grief becomes complicated grief can be difficult. […] Complicated grief may be considered when the intensity of grief has not decreased in the months after your loved one’s death. […] Some mental health professionals diagnose complicated grief when grieving continues to be intense, persistent and debilitating beyond 12 months. […] There are many similarities between complicated grief and major depression, but there are also distinct differences. […] Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done. […] There’s little solid research on the use of psychiatric medications to treat complicated grief. However, antidepressants may be helpful in people who have clinical depression as well as complicated grief.

• #72 Complicated Grief Can Be Complicated | Psychology Today

  https://www.psychologytoday.com/us/blog/good-mourning/202311/complicated-grief-can-be-complicated

  With the exception of PTSD, versions of the DSM before DSM-5 did not consider forms of complicated grief. […] The DSM-5-TR accepted a new disorder: prolonged grief disorder. […] Afterward, it was only in the DSM-5 (and subsequently the DSM-5-TR) that a variety of forms of complicated grief were acknowledged. […] The inclusion of prolonged grief disorder in the DSM-5-TR (2022) followed a long and circuitous route. […] Despite concerns and controversies, the DSM-5-TR (2022) has made considerable progress in acknowledging varied forms of complicated grief. […] The DSM-5-TR cannot be the end of that processonly the end of the beginning.

• #73 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Prevalence estimates for PGD appear to be quite similar across Western and non-Western countries, with the apparent higher rates in non-Western countries at least partially explained by confounding factors including the specificities of the specific populations studied. […] Overall, the existing literature supports that about 10% of individuals have been shown to go on developing PGD after the loss of a loved one. […] Therefore, no globally applicable criteria set exists yet. […] Validating and/or developing screening and assessment measures that are reliable across cultures is critical to support future cross-cultural research on grief reactions and PGD. […] The International Prolonged Grief Disorder Scale assesses PGD for the ICD-11 and includes a cultural supplement that offers information on culturally-relevant grief symptoms.

• #74 Complicated grief | Cruse Bereavement Support

  https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/

  Over time most people start to adapt and feel better after someone dies. When someone becomes stuck or is still unable to cope after many months it is sometimes known as complicated grief or prolonged grief disorder. […] Our understanding of complicated grief or prolonged grief disorder is still growing. The terms are often used interchangeably and in the UK people are not usually given them as a diagnosis by a doctor. […] Prolonged grief disorder or complicated grief is when intense, long-lasting symptoms of grief, together with ongoing problems and difficulties in coping with life, go on for more than six months after someone dies. […] There’s still a lot more to learn about complicated grief, but the following things are risk factors: […] If your child has died you may be more likely to experience complicated or prolonged grief. […] If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce.

• #75 Complicated Grief: Symptoms, Causes & Treatment

  https://laopcenter.com/mental-health/disorder/complicated-grief/

  Complicated grief lasts at least 12 months following the death of a loved one for adults and at least 6 months for children and adolescents, according to Shear MK, Simon N, et al. 2011 study entitled. Complicated Grief And Related Bereavement Issues For DSM-5. Depression and Anxiety, published in the PubMed Journal. Unlike normal grief, which tends to diminish over time, complicated grief symptoms persist indefinitely, leading to ongoing emotional distress and functional impairment.

• #76 Complicated grief or prolonged grief: how to cope | Marie Curie

  https://www.mariecurie.org.uk/information/grief/complicated-grief

  Complicated grief is when strong feelings have a significant impact on your daily life for more than 12 months. You are not alone around 1 in 10 (10%) of people experience complicated grief. Complicated grief is sometimes called prolonged grief disorder, persistent complex bereavement disorder or traumatic grief. Anyone can experience complicated grief. It’s about the impact that your loss has on your life. The following things make it more likely that you’ll experience complicated grief: You were very close to the person who died or if one of you was a carer for the other one. Your mental health if you’ve had depression, bipolar disorder, anxiety or post-traumatic stress disorder (PTSD). Many people experience complicated grief at the same time as these conditions. Sometimes a specialist will diagnose complicated grief when grief is affecting your daily life longer than 12 months after the person died. But other times they will diagnose it from 6 months. It depends on how your feelings are affecting your life.

• #77 Complicated grief – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/diagnosis-treatment/drc-20360389

  Grieving is a highly individual process for each person, and determining when normal grief becomes complicated grief can be difficult. […] Complicated grief may be considered when the intensity of grief has not decreased in the months after your loved one’s death. […] Some mental health professionals diagnose complicated grief when grieving continues to be intense, persistent and debilitating beyond 12 months. […] There are many similarities between complicated grief and major depression, but there are also distinct differences. […] Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done. […] There’s little solid research on the use of psychiatric medications to treat complicated grief. However, antidepressants may be helpful in people who have clinical depression as well as complicated grief.

• #78 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  The nature of the relationship to the deceased, personality traits, coping style, psychiatric history and comorbidities, and socioeconomic factors all contribute to the risk of CG. […] Studies conducted by Mancini et al. (2015) and Schenck et al. (2015) concluded that individuals with insecure attachment styles remained more focused on negative cognitions about the deceased than those with secure attachment styles. […] Findings also revealed a higher level of CG symptoms among bereaved individuals with insecure attachment styles. […] Although significant symptom overlap exists whether CG is primary or secondary to PTSD, each disorder has its own unique features. […] Common comorbidities and similar symptom overlap between CG and other mental health disorders add to the challenge of identifying optimal treatments.

• #79 Bereavement and Complicated Grief

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3855369/

  CG can be reliably detected with standardized measures, such as the Inventory of Complicated Grief (ICG). […] CG is associated with negative health and mental health consequences in older adults, beyond that of bereavement itself. […] Recent reviews summarize possible risk factors for CG and suggest these are seen across samples, nationalities and age groups. […] Given that CG can be reliably identified and differentiated from other mental disorders, and given its prevalence, we believe there is a need for an effective treatment. […] Treatments for CG have also been tested, with the 16-session Complicated Grief Treatment (CGT) showing the best evidence of efficacy, including a study in older adults.

• #80 Complicated grief – GPMHSC

  https://gpmhsc.org.au/guidelines/index/1998aae6-2bdc-4647-8820-7becb21bf3db

  Complicated grief is associated with substantial impairment in work, health and social functioning. […] About 10% of bereaved people experience complicated grief (also referred to as prolonged grief disorder and persistent complex bereavement-related disorder). This is a syndrome of prolonged (ie well beyond six months) or intense grief, resulting from a failure to transition from acute to integrated grief. Complicated grief is associated with substantial impairment in work, health and social functioning. […] People with complicated grief are at increased risk for cardiac disease, cancer, hypertension, substance-use disorders and suicidality. […] Several assessment instruments have been developed to screen and diagnose people with complicated grief. The Inventory of Complicated Grief is the instrument that has been most commonly used to identify complicated grief symptoms in research. […] Standard grief-focused supportive psychotherapies and psychotropic medications such as antidepressants do not appear to be effective for complicated grief. However, targeted complicated grief treatment has shown significant benefit.

• #81 Inventory of Complicated Grief (ICG) – Psychology Tools

  https://psychology-tools.com/test/inventory-complicated-grief

  Grief is a natural response to loss, encompassing a range of emotional, cognitive, and behavioral reactions. However, in some cases, individuals experience an extended and profound form of grief, known as complicated grief (CG). This condition, also referred to as prolonged grief disorder, is characterized by persistent intense sorrow, preoccupation with the deceased, and difficulty moving on with life, long after the loss has occurred. Complicated grief can lead to significant disruptions in daily functioning and overall well-being. […] In response to the need for a standardized measure to assess this specific form of grief, Prigerson et al. developed the Inventory of Complicated Grief (ICG). The ICG is designed to identify and quantify the symptoms of complicated grief, differentiating them from those typically associated with bereavement-related depression and anxiety. Research has demonstrated that certain symptoms specific to complicated grief, such as persistent yearning, intense sorrow, and avoidance of reminders of the loss, are distinct from the emotional patterns observed in other grief-related psychological conditions.

• #82 The difficult case of complicated grief and the role of phenomenology in psychiatry

  https://journals.openedition.org/phenomenology/1334

  It has been argued that some unremitting forms of grief, commonly labeled as complicated grief, pose a serious threat to the well-being and life of the mourner and may require clinical attention (Lichtenthal et al., 2004; Zisook et al., 2010). […] Complicated grief (CG) is a commonly used term to describe the latter (Zisook Shear, 2009). The need for diagnostic criteria for CG has been recognized in recent and forthcoming editions of diagnostic manuals that provide operationalized criteria for mental disorders (DSM-5; ICD-11 Beta draft). […] Complicated grief is indicated by the score equal or higher than 30 at the time of six months after the loss. Several studies suggest that the score qualifying for CG on that scale is correlated with impairment and negative health consequences, such as: sleep disturbances (Hardison et al., 2005); daily routine disruptions (Monk et al., 2006); increased risk for cancer, cardiac disease, substance abuse and suicidality (Prigerson et al., 1999; Szanto et al., 2006).

• #83 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Prevalence estimates for PGD appear to be quite similar across Western and non-Western countries, with the apparent higher rates in non-Western countries at least partially explained by confounding factors including the specificities of the specific populations studied. […] Overall, the existing literature supports that about 10% of individuals have been shown to go on developing PGD after the loss of a loved one. […] Therefore, no globally applicable criteria set exists yet. […] Validating and/or developing screening and assessment measures that are reliable across cultures is critical to support future cross-cultural research on grief reactions and PGD. […] The International Prolonged Grief Disorder Scale assesses PGD for the ICD-11 and includes a cultural supplement that offers information on culturally-relevant grief symptoms.

• #84 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Regardless of who experiences it, prolonged grief comes with increased health risks. In Shears work, suicidality, heart trouble, cancer, and other physical ailments often accompany the conditions emotional effects. […] In spite of its debilitating consequences, prolonged grief is often an overlooked diagnosis. […] To improve how prolonged grief was identified and diagnosed, Prigerson and her colleagues established a 19-item inventory for screening patients. […] Many of our patients actually self-identify, says Shear. […] Shear and others have determined that patients experiencing prolonged grief generally do not respond to the types of treatments traditionally used to address depression and PTSD, and they have worked to establish a separate protocol for treating the condition. […] The good news is that complicated grief patients have an immense capacity to heal and pull through, Shear says.

• #85 The difficult case of complicated grief and the role of phenomenology in psychiatry

  https://journals.openedition.org/phenomenology/1334

  It has been argued that some unremitting forms of grief, commonly labeled as complicated grief, pose a serious threat to the well-being and life of the mourner and may require clinical attention (Lichtenthal et al., 2004; Zisook et al., 2010). […] Complicated grief (CG) is a commonly used term to describe the latter (Zisook Shear, 2009). The need for diagnostic criteria for CG has been recognized in recent and forthcoming editions of diagnostic manuals that provide operationalized criteria for mental disorders (DSM-5; ICD-11 Beta draft). […] Complicated grief is indicated by the score equal or higher than 30 at the time of six months after the loss. Several studies suggest that the score qualifying for CG on that scale is correlated with impairment and negative health consequences, such as: sleep disturbances (Hardison et al., 2005); daily routine disruptions (Monk et al., 2006); increased risk for cancer, cardiac disease, substance abuse and suicidality (Prigerson et al., 1999; Szanto et al., 2006).

• #86 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  A minority of people who experience cognitive, emotional, and behavioral grief responses to bereavement will develop a mental health condition recently identified as prolonged grief disorder (PGD). […] Given the heterogeneity in PGD prevalence estimates across the globe, specific populations may be at more risk for PGD, possibly due to risk factors associated with the mechanisms of loss, such as population specificities (e.g., refugees, migrants, and conflict survivors). […] As evidence-based treatment for PGD has limited cultural adaptations, cross-cultural development and validation of PGD screening and assessment may be critical to support future research on grief reactions and PGD. […] To be able to address PGD at the global level, we will thus need to develop a stepped-care model in which the most effective, yet least resource-taxing treatment is delivered first, only stepping up to more resource-using treatments as required, which could decrease the health burden at the individuals level while controlling costs and improving health-care systems efficiency.

• #87

  https://link.springer.com/article/10.1007/s00127-023-02469-1

  This study highlights that some symptoms of PGD are commonly reported in the general population, although relatively few meet the criteria for clinical significance. […] The routine assessment for PGD following a bereavement is discussed and the development of appropriate interventions are recommended. […] The present study also sought to look at the association between prior mental health treatment and PGD, however, no a priori hypotheses were developed due to the paucity of research in this area. […] The current study had two primary aims: (1) report the levels of PGD symptoms, and estimate rates of moderate/strict PGD, and (2) identify sociodemographic, loss, and mental health related correlates of ICD-11 PGD (moderate and strict) using data from a large, nationally representative sample of UK adults.

• #88 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  PGD is estimated to be experienced by about 10 percent of bereaved survivors, although rates vary substantially depending on populations sampled and definitions used. […] According to a 2017 meta-analysis, prevalence of prolonged grief is estimated to be 9.8%, although higher prevalence estimates, as high as 49%, are possible if the death was not due to natural causes. […] PGD is also more prevalent when the death is by a violent method such as homicide or suicide, with an estimated 70% of those with PGD in the study having been exposed to bereavement by a violent method. […] Conversely, PGD is less common in cases where the bereaved death was due to natural disasters. […] PGD has higher prevalence in women. […] A 2021 meta-analysis identified a global prevalence of 14.2% in prolonged grief disorders among bereaved families dealing with cancer-related deaths.

• #89 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Research has investigated the prevalence of PGD across the globe using mostly standard grief questionnaires, developed in and for Westernized countries. […] According to the meta-analysis of Lundorff et al. (2017), a pooled prevalence rate of 9.8% was found in 14 studies across the world among bereaved adults who experienced mostly nonviolent deaths of a loved one. […] In non-Westernized lower-to-middle-income countries, PGD prevalence appears to be relatively higher than in high-income countries, but also shows heterogeneity across countries. […] Higher prevalence estimates have been found in bereaved after losing a loved one due to an unnatural cause of death. […] The existing cross-sectional studies on PGD in non-Westernized populations predominantly investigated adult refugee populations living in Westernized countries, as they are at high risk for traumatization and loss, and relatively high prevalence rates have been reported.

• #90 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

• #91 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Despite the fact that prolonged grief is getting more recognition these days, there remains an overall lack of awareness of it in the medical community. […] We do not have a system or a set of routine practices for caring for the bereaved, adds Block. This makes identifying a case of prolonged grief much less likely. […] This may be especially true now. The pandemic has at least brought grief, including prolonged grief, into a space of better awareness, Block says, but bereavement care in general has been inadequate throughout the pandemic because the health care system has been overwhelmed.

• #92 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Despite the fact that prolonged grief is getting more recognition these days, there remains an overall lack of awareness of it in the medical community. […] We do not have a system or a set of routine practices for caring for the bereaved, adds Block. This makes identifying a case of prolonged grief much less likely. […] This may be especially true now. The pandemic has at least brought grief, including prolonged grief, into a space of better awareness, Block says, but bereavement care in general has been inadequate throughout the pandemic because the health care system has been overwhelmed.

• #93 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. […] Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost. […] There are many public health benefits now that PGD is in the DSM-5-TR. Insurance companies can now cover the cost of treatment for bereaved individuals diagnosed with PGD. Mental health clinicians would be more knowledgeable and now have a better understanding of grief. […] Additionally, there is now greater public awareness and recognition of PGD as a public health issue.

• #94 Treating Prolonged Grief Disorder: Innovations and Future Directions

  https://www.psychiatrictimes.com/view/treating-prolonged-grief-disorder-innovations-and-future-directions

  Prolonged grief disorder (PGD), investigated for many years under various labels including complicated grief, traumatic grief, or persistent complex bereavement disorder, was recently added to the DSM-5-TR and the ICD-11. It is estimated to affect 9.8% to 11% of bereaved adults, translating to millions of individuals worldwide. PGD is associated with functional impairment and suicidal ideation. Improving access to treatment for PGD is an important public health priority. […] The community is also experiencing ongoing dangerous and unchecked racism, with its associated inequities and injustices such as racial profiling, police violence, disparities in health, access to medical care, educational and economic opportunities, mass incarceration, voter suppression, employment discrimination, and higher exposure to environmental hazards. These ongoing disparities and inequities add to the burden of bereavement, reduce availability of effective social support, and increase the likelihood of mental and physical grief complications in communities such as Harlem.

• #95 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. […] Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost. […] There are many public health benefits now that PGD is in the DSM-5-TR. Insurance companies can now cover the cost of treatment for bereaved individuals diagnosed with PGD. Mental health clinicians would be more knowledgeable and now have a better understanding of grief. […] Additionally, there is now greater public awareness and recognition of PGD as a public health issue.

• #96 Psychiatry.org – APA Offers Tips for Understanding Prolonged Grief Disorder

  https://www.psychiatry.org/news-room/news-releases/apa-offers-tips-for-understanding-prolonged-grief

  Prolonged grief disorder was recently added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a volume published by the American Psychiatric Association (APA) that defines and classifies mental disorders. […] Prolonged grief disorder is the newest disorder to be added to the DSM. After studies dating back several decades suggested that many people were experiencing persistent difficulties associated with bereavement that are substantially prolonged beyond culturally normed expectations, and a two-year process of review and public comment, APAs Board of Trustees and Assembly approved it last fall for inclusion in the DSM. It will be included in the new text revision of DSM-5 (DSM-5-TR), which is slated for release in March 2022. […] Including prolonged grief disorder in the DSM-5-TR will mean that mental health clinicians and patients and families alike share an understanding of what normal grief looks like and what might indicate a long-term problem, said APA CEO and Medical Director Saul Levin, M.D., M.P.A. Especially now, sharing information and increasing awareness about prolonged grief disorder is essential.

• #97 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. […] Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost. […] There are many public health benefits now that PGD is in the DSM-5-TR. Insurance companies can now cover the cost of treatment for bereaved individuals diagnosed with PGD. Mental health clinicians would be more knowledgeable and now have a better understanding of grief. […] Additionally, there is now greater public awareness and recognition of PGD as a public health issue.

• #98 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. […] Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost. […] There are many public health benefits now that PGD is in the DSM-5-TR. Insurance companies can now cover the cost of treatment for bereaved individuals diagnosed with PGD. Mental health clinicians would be more knowledgeable and now have a better understanding of grief. […] Additionally, there is now greater public awareness and recognition of PGD as a public health issue.

• #99 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. […] Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost. […] There are many public health benefits now that PGD is in the DSM-5-TR. Insurance companies can now cover the cost of treatment for bereaved individuals diagnosed with PGD. Mental health clinicians would be more knowledgeable and now have a better understanding of grief. […] Additionally, there is now greater public awareness and recognition of PGD as a public health issue.

• #100 Psychiatry.org – APA Offers Tips for Understanding Prolonged Grief Disorder

  https://www.psychiatry.org/news-room/news-releases/apa-offers-tips-for-understanding-prolonged-grief

  Prolonged grief disorder was recently added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a volume published by the American Psychiatric Association (APA) that defines and classifies mental disorders. […] Prolonged grief disorder is the newest disorder to be added to the DSM. After studies dating back several decades suggested that many people were experiencing persistent difficulties associated with bereavement that are substantially prolonged beyond culturally normed expectations, and a two-year process of review and public comment, APAs Board of Trustees and Assembly approved it last fall for inclusion in the DSM. It will be included in the new text revision of DSM-5 (DSM-5-TR), which is slated for release in March 2022. […] Including prolonged grief disorder in the DSM-5-TR will mean that mental health clinicians and patients and families alike share an understanding of what normal grief looks like and what might indicate a long-term problem, said APA CEO and Medical Director Saul Levin, M.D., M.P.A. Especially now, sharing information and increasing awareness about prolonged grief disorder is essential.

• #101 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Other results have reported female sex and low social support as risk factors for prolonged grief. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. […] Grief can manifest differently in patients of varying ages. […] If the death occurred in a traumatic fashion, it may bring up recurrent images of the trauma or complicated emotions ranging from self-blame to fear or desires for vengeance. […] Seeking the consultation of a professional trained in developmental stages and their influence on the grieving process to support a child’s grieving process is advised. […] The course depends on how patients adapt to their new reality. This is contingent upon their personal resiliency, support system, and psychiatric assistance. […] The effective management of grief reactions and prolonged grief disorder requires a comprehensive approach that involves various healthcare professionals to enhance patient-centered care, outcomes, patient safety, and team performance.

• #102 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  A minority of people who experience cognitive, emotional, and behavioral grief responses to bereavement will develop a mental health condition recently identified as prolonged grief disorder (PGD). […] Given the heterogeneity in PGD prevalence estimates across the globe, specific populations may be at more risk for PGD, possibly due to risk factors associated with the mechanisms of loss, such as population specificities (e.g., refugees, migrants, and conflict survivors). […] As evidence-based treatment for PGD has limited cultural adaptations, cross-cultural development and validation of PGD screening and assessment may be critical to support future research on grief reactions and PGD. […] To be able to address PGD at the global level, we will thus need to develop a stepped-care model in which the most effective, yet least resource-taxing treatment is delivered first, only stepping up to more resource-using treatments as required, which could decrease the health burden at the individuals level while controlling costs and improving health-care systems efficiency.

• #103 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

• #104 Treating Prolonged Grief Disorder: Innovations and Future Directions

  https://www.psychiatrictimes.com/view/treating-prolonged-grief-disorder-innovations-and-future-directions

  Prolonged grief disorder (PGD), investigated for many years under various labels including complicated grief, traumatic grief, or persistent complex bereavement disorder, was recently added to the DSM-5-TR and the ICD-11. It is estimated to affect 9.8% to 11% of bereaved adults, translating to millions of individuals worldwide. PGD is associated with functional impairment and suicidal ideation. Improving access to treatment for PGD is an important public health priority. […] The community is also experiencing ongoing dangerous and unchecked racism, with its associated inequities and injustices such as racial profiling, police violence, disparities in health, access to medical care, educational and economic opportunities, mass incarceration, voter suppression, employment discrimination, and higher exposure to environmental hazards. These ongoing disparities and inequities add to the burden of bereavement, reduce availability of effective social support, and increase the likelihood of mental and physical grief complications in communities such as Harlem.

• #105 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  A minority of people who experience cognitive, emotional, and behavioral grief responses to bereavement will develop a mental health condition recently identified as prolonged grief disorder (PGD). […] Given the heterogeneity in PGD prevalence estimates across the globe, specific populations may be at more risk for PGD, possibly due to risk factors associated with the mechanisms of loss, such as population specificities (e.g., refugees, migrants, and conflict survivors). […] As evidence-based treatment for PGD has limited cultural adaptations, cross-cultural development and validation of PGD screening and assessment may be critical to support future research on grief reactions and PGD. […] To be able to address PGD at the global level, we will thus need to develop a stepped-care model in which the most effective, yet least resource-taxing treatment is delivered first, only stepping up to more resource-using treatments as required, which could decrease the health burden at the individuals level while controlling costs and improving health-care systems efficiency.

• #106 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Other results have reported female sex and low social support as risk factors for prolonged grief. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. […] Grief can manifest differently in patients of varying ages. […] If the death occurred in a traumatic fashion, it may bring up recurrent images of the trauma or complicated emotions ranging from self-blame to fear or desires for vengeance. […] Seeking the consultation of a professional trained in developmental stages and their influence on the grieving process to support a child’s grieving process is advised. […] The course depends on how patients adapt to their new reality. This is contingent upon their personal resiliency, support system, and psychiatric assistance. […] The effective management of grief reactions and prolonged grief disorder requires a comprehensive approach that involves various healthcare professionals to enhance patient-centered care, outcomes, patient safety, and team performance.

• #107 JMIR Mental Health – Therapist-Assisted Web-Based Intervention for Prolonged Grief Disorder After Cancer Bereavement: Randomized Controlled Trial

  https://mental.jmir.org/2022/2/e27642

  Background: Bereavement due to cancer increases the risk of prolonged grief disorder. However, specialized treatment options for prolonged grief after a loss due to illness are still scarce. […] A loss due to illness may cause specific additional strains for the bereaved, which increases the risk of developing PGD. Bereavement due to cancer has been identified as a risk factor for PGD. […] Internet-based treatments offer an effective, flexible, and more anonymous approach for addressing mental health issues, which may help overcome treatment barriers for those with PGD. […] Web-based approaches should therefore be considered in future mental health care policies and practices.

• #108 Treating Prolonged Grief Disorder: Innovations and Future Directions

  https://www.psychiatrictimes.com/view/treating-prolonged-grief-disorder-innovations-and-future-directions

  Given the impact of sociocultural stressors, coupled with the disproportionate impact of COVID-19 on Black communities, our research team is finalizing the modification of a digital intervention named GriefCare for Harlem. This is a self-guided digital app that is informed by our focus groups and will be refined through community consultation. We eventually plan to evaluate this culturally tailored digital intervention in a randomized controlled trial.

• #109 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

• #110 Treating Prolonged Grief Disorder: Innovations and Future Directions

  https://www.psychiatrictimes.com/view/treating-prolonged-grief-disorder-innovations-and-future-directions

  Prolonged grief disorder (PGD), investigated for many years under various labels including complicated grief, traumatic grief, or persistent complex bereavement disorder, was recently added to the DSM-5-TR and the ICD-11. It is estimated to affect 9.8% to 11% of bereaved adults, translating to millions of individuals worldwide. PGD is associated with functional impairment and suicidal ideation. Improving access to treatment for PGD is an important public health priority. […] The community is also experiencing ongoing dangerous and unchecked racism, with its associated inequities and injustices such as racial profiling, police violence, disparities in health, access to medical care, educational and economic opportunities, mass incarceration, voter suppression, employment discrimination, and higher exposure to environmental hazards. These ongoing disparities and inequities add to the burden of bereavement, reduce availability of effective social support, and increase the likelihood of mental and physical grief complications in communities such as Harlem.

• #111 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

• #112 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

• #113 Complicated grief following the perinatal loss: a systematic review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06986-y

  This systematic review found that CG is indeed common in parents with perinatal loss. We note several key clinical findings, for the symptoms of CG following perinatal loss are diverse, not only in terms of emotional reactions, but also in terms of a certain degree of negative impact on physical health, and even in terms of impediments to normal social interactions; moreover, in addition to the general influencing factors, social support and coping strategies play an important role in influencing the situation.

• #114 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

• #115 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Research has investigated the prevalence of PGD across the globe using mostly standard grief questionnaires, developed in and for Westernized countries. […] According to the meta-analysis of Lundorff et al. (2017), a pooled prevalence rate of 9.8% was found in 14 studies across the world among bereaved adults who experienced mostly nonviolent deaths of a loved one. […] In non-Westernized lower-to-middle-income countries, PGD prevalence appears to be relatively higher than in high-income countries, but also shows heterogeneity across countries. […] Higher prevalence estimates have been found in bereaved after losing a loved one due to an unnatural cause of death. […] The existing cross-sectional studies on PGD in non-Westernized populations predominantly investigated adult refugee populations living in Westernized countries, as they are at high risk for traumatization and loss, and relatively high prevalence rates have been reported.

• #116 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Although Complicated Grief Treatment has been shown to be an effective treatment for CG symptoms, it is not widely available and typically requires a relatively lengthy treatment period. […] Future studies should focus on efficient ways of delivering treatment for CG and other effective forms of psychotherapy to more individuals. […] Research studies that inform behavioral health and medical practitioners must include family, social, cultural, and environmental constructs when developing intervention programs.

• #117 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Although Complicated Grief Treatment has been shown to be an effective treatment for CG symptoms, it is not widely available and typically requires a relatively lengthy treatment period. […] Future studies should focus on efficient ways of delivering treatment for CG and other effective forms of psychotherapy to more individuals. […] Research studies that inform behavioral health and medical practitioners must include family, social, cultural, and environmental constructs when developing intervention programs.

• #118 JMIR Mental Health – Therapist-Assisted Web-Based Intervention for Prolonged Grief Disorder After Cancer Bereavement: Randomized Controlled Trial

  https://mental.jmir.org/2022/2/e27642

  Background: Bereavement due to cancer increases the risk of prolonged grief disorder. However, specialized treatment options for prolonged grief after a loss due to illness are still scarce. […] A loss due to illness may cause specific additional strains for the bereaved, which increases the risk of developing PGD. Bereavement due to cancer has been identified as a risk factor for PGD. […] Internet-based treatments offer an effective, flexible, and more anonymous approach for addressing mental health issues, which may help overcome treatment barriers for those with PGD. […] Web-based approaches should therefore be considered in future mental health care policies and practices.

• #119 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Although Complicated Grief Treatment has been shown to be an effective treatment for CG symptoms, it is not widely available and typically requires a relatively lengthy treatment period. […] Future studies should focus on efficient ways of delivering treatment for CG and other effective forms of psychotherapy to more individuals. […] Research studies that inform behavioral health and medical practitioners must include family, social, cultural, and environmental constructs when developing intervention programs.

• #120 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  Additionally, losing a loved one during the COVID-19 pandemic is a risk factor for PGD, with communities of color potentially being at higher risk due to racial disparities in COVID-19 deaths. […] One of these factors was COVID-19, with many bereavement experts believing that the unprecedented amount of deaths from COVID-19 would lead to an increase in incidences of PGD making PGD a major public health concern. […] Approximately 10% of bereaved children and adults experience PGD and its symptoms, although almost no studies have examined the incidence or prevalence rates of PGD in youth, which can manifest differently than in adults. […] PGD is characterized by intense and persistent grief reactions that can become maladaptive if these reactions cause impairment to daily life, as well as hinder a bereaved individual’s ability to be able to successfully cope with their grief in a healthy way.

• #121 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

• #122 Bereavement issues and prolonged grief disorder: A global perspective | Cambridge Prisms: Global Mental Health | Cambridge Core

  https://www.cambridge.org/core/journals/global-mental-health/article/bereavement-issues-and-prolonged-grief-disorder-a-global-perspective/F401F072E4CD874D5DBDFF4A7A540F35

  Thus, important cross-cultural knowledge is still lacking and hampers the validity of DSM-5-TR or ICD-11 PGD diagnostic criteria across other cultures, and further research on the specific cultural expressions and symptoms of PGD, and how these differential symptom expressions may impact screening and treatment strategies, are warranted. […] To date, the treatment with the most empirical support for PGD is a 16-session individual therapy that has shown efficacy across three large randomized controlled trials. […] The identification of key culture-bound symptoms of anxiety and trauma-related disorders has previously supported their inclusion in DSM-5 and shows how trauma may result in particular symptoms in a specific cultural context. […] It is thus possible that more transcultural research on other trauma-related issues such as PGD will lead to the identification of specific culture-bound symptoms of PGD and the adaptation of current treatment protocols. […] Major world events such as pandemics, conflicts, and climate-change-induced natural disasters could have a profound impact on rates of PGD in the world in the near future. […] PGD treatment capacity building worldwide is needed but will likely not be enough.

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