Prolonged grief disorder

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Prolonged grief disorder
Other namesComplicated grief, Persistent complex bereavement disorder
Grief - old woman (70-ies).jpg
Specialty Psychiatry, psychology
Symptoms Prolonged grief, Depression, emotional pain, emotional numbness, loneliness, identity disturbance, difficulty in managing interpersonal relationships
Complications suicide, self harm, relationship damage
Differential diagnosis Borderline personality disorder, Complex post-traumatic stress disorder, Grief not otherwise specified, Major depressive disorder, Post-traumatic stress disorder

Prolonged grief disorder (PGD), also known as complicated grief (CG), [1] traumatic grief (TG) [2] and persistent complex bereavement disorder (PCBD) in the DSM-5, [3] is a mental disorder consisting of a distinct set of symptoms following the death of a family member or close friend (i.e. bereavement). People with PGD are preoccupied by grief and feelings of loss to the point of clinically significant distress and impairment, which can manifest in a variety of symptoms including depression, emotional pain, emotional numbness, loneliness, identity disturbance and difficulty in managing interpersonal relationships. Difficulty accepting the loss is also common, which can present as rumination about the death, a strong desire for reunion with the departed, or disbelief that the death occurred. PGD is estimated to be experienced by about 10 percent of bereaved survivors, although rates vary substantially depending on populations sampled and definitions used. [4]

Contents

In March 2022, PGD was added as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) with diagnostic code F43.8. PGD is also in the eleventh revision of the International Classification of Diseases (ICD-11) under code 6B42. To meet diagnosis, symptoms must occur frequently (usually at least daily) and be present for at least 6–12 months.

Symptoms

PGD behavioral symptoms include:

PGD is also a risk factor a variety of somatic symptoms [9] possibly including:

The individual's relationship to the deceased accounts for a large amount of variance in symptoms. Spouses, parents, and children of deceased tend to display highest severities, followed by siblings, in-laws, and friends. Subjective closeness to deceased has also been found to be an important predictor of pathologic grief responses. [12] Bereaved persons often feel a need to understand why their loved one died by suicide, particularly if a message was not left behind by the deceased. [13]

Grief is a common response to bereavement, occurring in a variety of severities and durations, however only a minority of cases of grief meet the severity and duration criteria to merit diagnosis of PGD; it is considered when an individual's ability to function and level of distress over the loss is extreme and persistent. [14] People with PGD can experience a chronic aching and yearning for the dear departed, feel that they are not the same person anymore (identity disturbance), become emotionally disconnected from others, or lack the desire to "move on" (in some cases feeling that doing so would be betraying the person who is now deceased). [7] [8] [6] Although normal grief remains with the bereaved person far into the future, its ability to disrupt the survivor's life is believed to dissipate with time. [15]

Since the 1990s, studies have demonstrated the validity of distinguishing PGD from mental disorders with similar symptom clusters, specifically major depressive disorder and post-traumatic stress disorder. [16] [7] Validity has also been demonstrated for the DSM-5-TR criteria. [17]

Diagnosis

DSM-5-TR

In the DSM-5-TR, prolonged grief disorder is a classified as a "trauma and stressor-related disorder". [18] Along with bereavement of the individual occurring at least one year ago (or six months in children and adolescents), there must be evidence of one of two "grief responses" occurring at least daily for the past month:

Additionally, the individual must have at least three of the following symptoms occurring at least daily for the past month:

The duration and severity of the distress and impairment in PGD must be clinically significant, and not better explainable by social, cultural or religious norms, or another mental disorder. PGD can be distinguished from depressive disorders with distress appearing specifically about the bereaved as opposed to a general low mood. According to Holly Prigerson, an editor on the trauma and stressor-related disorder section of the DSM-5-TR, "intense, persistent yearning for the deceased person is specifically a characteristic symptom of PG [prolonged grief], but is not a symptom of MDD (or any other DSM disorder)". [15]

ICD-11

In the ICD-11, the symptoms required for diagnosis are: [19]

Compared to the DSM-5-TR diagnostic criteria, the ICD-11 requires grief responses to be present for only six months in adults as compared to one year in the DSM-5-TR.

Diagnostic criteria for PGD for inclusion in the DSM-5 and ICD-11 were proposed and revised as early as 2009. [7] However, the DSM-5 did not include PGD, only later being included in the DSM-5-TR.

Assessment tools

Multiple assessment tools specifically for grief related to bereavement have been developed. The first such assessment tool was the Inventory of Complicated Grief (ICG) in 1995. [20] As of 2021 the ICG remains widely used. [21] According to a 2020 systematic review, there were eleven assessment tools at the time, three of which are designed for clinical interviews. [3] The Traumatic Grief Inventory Self-Report [22] was the only assessment tool found to have empirical evidence supporting use as a diagnostic tool. [3] Later evidence suggested the ICG also remains an effective clinical assessment tool. [21]

Causes

No specific causes guarantee onset of PGD. Known risk factors include one-time incidents along with chronic conditions and neurological abnormalities. One-time incidents include:

Long-term predictors include:

Two neurological abnormalities are also suspected to correlate with PGD:

These risk factors and clinical correlates have been largely shown to relate to PGD symptoms and not symptoms of major depressive disorder, posttraumatic stress disorder and generalized anxiety disorder. [28] [36]

Management

Randomized control trials have proven tricyclic antidepressants alone or together with interpersonal psychotherapy effective in reducing PGD symptoms, and psychotherapy designed specifically for PGD has been proven to be beneficial. [38] [39] [40] [41]

A combination of relational and cognitive-behavioral interventions have shown evidence for efficacy when treating individuals who have lost loved ones to suicide. [13] This includes interventions that target the client's sense of self and lingering emotional attachment to the deceased, as well as any experiences of intrusion, anxiety, and/or avoidance. Acceptance of irreversibility of the death is considered a prerequisite for acceptance and acknowledgement of the loss. Exposure therapy has mixed evidence and in some cases intensifies symptoms, suggesting effectiveness does not vary significantly compared to non-exposure therapies especially with comorbid PTSD. [42] [13] Group therapy has mixed evidence, and has been shown to be less helpful when compared to other treatments. [13]

Epidemiology

According to a 2017 meta-analysis, prevalence ranges are estimated to be 9.8%, although later evidence in 2020 has suggested higher prevalence estimates, as high as 49% of bereaved individuals. [4] [43] [44] 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. [23] Conversely, PGD is less common in cases where the bereaved death was due to natural disasters. [44] [45] PGD has higher prevalence in women. [23] [44] There is a high comorbidity rate with somatic symptom disorders, [9] depression, anxiety and post-traumatic stress disorder, with PGS being observed as heterogenous. [46]

There exists conflicting evidence on whether PGD is more or less common in eastern countries compared to western countries. [4] [44]

History

The DSM-IV and ICD-10 do not distinguish between normal and prolonged grief. [47] [48] Based on numerous findings of maladaptive effects of prolonged grief, diagnostic criteria for PGD have been proposed for inclusion in the DSM-5 and ICD-11. [7] [49] In 2018, the WHO included PGD in the ICD-11, [50] and in March 2022 the American Psychiatric Association added PGD in the DSM-5-TR. [18]

The proposed diagnostic criteria were the result of statistical analysis of a set of criteria agreed upon by a panel of experts. [7] [51] The analyses produced criteria that were the most accurate markers of bereaved individuals with painful, persistent, destructive PGD. [7] The criteria for PGD have been validated and dozens of studies both internationally and domestically are being conducted, and published, that validate the PGD criteria in other cultures, kinship relationships to the deceased and causes of death (e.g. earthquakes, tsunami, war, genocide, fires, bombings, palliative and acute care settings). [52] [53]

Traumatic grief (TG) or complicated grief was a term initially used to identify a complex syndrome in which an individual experiences a unique distress resulting from the simultaneous occurrence of psychological trauma and the loss of a loved one. It was understood to be closely related to, but distinguished from, normal grief and post traumatic stress disorder. The central components originally included yearning, separation distress, and inability to acknowledge the loss. [54]

Controversy

Although evidence suggesting the validity of PGD has existed since 1995, [16] its inclusion into the DSM-5-TR and ICD-11 was slow, including many rejections of earlier proposals for inclusion as a diagnosis. Part of the rationale for this rejection was a concern that "[...] introducing a grief diagnosis would pathologize normal grief reactions and potentially lead to over-prescription of psychotropic medication for the bereaved." [55]

Recognizing prolonged grief as a disorder was argued to allow it to be better understood, detected, studied and treated. Insurance companies would also be more likely reimburse its care. However, inclusion of PGD in the DSM-5 and ICD-11 was thought at risk of being misunderstood as medicalization of grief, reducing its dignity, turning love into pathology and implying that survivors should quickly forget and "get over" the loss. Bereaved persons may be insulted by having their distress labeled as a mental disorder. While stigmatization would not be the intent, it might be an unintended consequence. In spite of this concern, studies have shown good accuracy for the ICD-11 and DSM-5-TR definitions, and that nearly all bereaved individuals who met the criteria for PGD were receptive to treatment and their families relieved to know they had a recognizable syndrome. [56] In addition, a 2020 study found that labeling PGD symptoms with a grief-specific diagnosis does not produce additional public stigma beyond the stigma of these severe grief reactions alone. [57]

Stigma

Historically, there have been systemic consequences for family members that survive a loved one's suicide. During the Middle Ages families were often excommunicated and taxed by the Church if a family member had died by suicide. This often led to families losing their landholdings, inevitably being forced to live in poverty or emigrate to another region. [58]

Some insurance policies prevent benefits from being accessed if an individual has died by suicide within a certain timeframe of taking out the policy. [58]

Related Research Articles

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The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the United States and Australia, while in other countries it may be used in conjunction with other documents. The DSM-5 is considered one of the principal guides of psychiatry, along with the International Classification of Diseases (ICD), Chinese Classification of Mental Disorders (CCMD), and the Psychodynamic Diagnostic Manual. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Grief</span> Response to loss in humans and other animals

Grief is the response to the loss of something deemed important, particularly to the loss of someone or some living thing that has died, to which a bond or affection was formed. Although conventionally focused on the emotional response to loss, grief also has physical, cognitive, behavioral, social, cultural, spiritual and philosophical dimensions. While the terms are often used interchangeably, bereavement refers to the state of loss, while grief is the reaction to that loss.

<span class="mw-page-title-main">Somatization disorder</span> Mental disorder consisting of clinically significant somatic symptoms

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Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

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<span class="mw-page-title-main">DSM-5</span> 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders

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<span class="mw-page-title-main">Grief counseling</span> Therapy for responses to loss

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Suicide bereavement is the experience of those who are grieving the loss of someone to suicide. Over 800,000 individuals die by suicide every year. It was stated by Shneidman (1978) that every suicide leaves behind 6 "survivor-victims". However, new research shows that each suicide leaves behind approximately 135 who personally knew the decedent. The #not6 hashtag has been used by Cerel and colleagues to represent that suicide bereavement is many more than publicly portrayed.

Bereavement groups, or grief groups, are a type of support group that bereaved individuals may access to have a space to process through or receive social support around grief. Bereavement groups are typically one of the most common services offered to bereaved individuals, encompassing both formalized group therapy settings for reducing clinical levels of grief as well as support groups that offer support, information, and exchange between those who have experienced loss.

References

  1. 1 2 Zordan, Rachel D.; Bell, Melanie L.; Price, Melanie; Remedios, Cheryl; Lobb, Elizabeth; Hall, Christopher; Hudson, Peter (2019-02-15). "Long-term prevalence and predictors of prolonged grief disorder amongst bereaved cancer caregivers: A cohort study". Palliative and Supportive Care. 17 (5): 507–514. doi:10.1017/s1478951518001013. ISSN   1478-9515. PMID   30767818. S2CID   73430241.
  2. ↑ Mutabaruka, Jean; Séjourné, Nathalène; Bui, Eric; Birmes, Philippe; Chabrol, Henri (2011-10-05). "Traumatic Grief and Traumatic Stress in Survivors 12 Years after the Genocide in Rwanda". Stress and Health. 28 (4): 289–296. doi:10.1002/smi.1429. ISSN   1532-3005. PMID   22282057.
  3. 1 2 3 Treml, Julia; Kaiser, Julia; Plexnies, Anna; Kersting, Anette (September 2020). "Assessing prolonged grief disorder: A systematic review of assessment instruments". Journal of Affective Disorders. 274: 420–434. doi:10.1016/j.jad.2020.05.049. ISSN   0165-0327. PMID   32663972. S2CID   219497064.
  4. 1 2 3 Lundorff, Marie; Holmgren, Helle; Zachariae, Robert; Farver-Vestergaard, Ingeborg; O'Connor, Maja (April 2017). "Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis". Journal of Affective Disorders. 212: 138–149. doi:10.1016/j.jad.2017.01.030. ISSN   0165-0327. PMID   28167398.
  5. ↑ Sekowski, M; Prigerson, H. G. (November 2022). "Associations between symptoms of prolonged grief disorder and depression and suicidal ideation". British Journal of Clinical Psychology. 61 (4): 1211–1218. doi:10.1111/bjc.12381. ISSN   0144-6657. PMID   35869636. S2CID   250990108.
  6. 1 2 Prigerson HG, Bridge J, Maciejewski PK, Beery LC, Rosenheck RA, Jacobs SC, et al. (December 1999). "Influence of traumatic grief on suicidal ideation among young adults". The American Journal of Psychiatry. 156 (12): 1994–5. doi:10.1176/ajp.156.12.1994. PMID   10588419. S2CID   39108484.
  7. 1 2 3 4 5 6 7 Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, Goodkin K, et al. (August 2009). Brayne C (ed.). "Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11". PLOS Medicine. 6 (8): e1000121. doi: 10.1371/journal.pmed.1000121 . PMC   2711304 . PMID   19652695.
  8. 1 2 3 4 5 6 Prigerson HG, Bierhals AJ, Kasl SV, Reynolds CF, Shear MK, Day N, et al. (May 1997). "Traumatic grief as a risk factor for mental and physical morbidity". The American Journal of Psychiatry. 154 (5): 616–23. doi: 10.1176/ajp.154.5.616 . PMID   9137115.
  9. 1 2 3 Rosner, Rita; Rimane, Eline; Vogel, Anna; Rau, Jörn; Hagl, Maria (2018-04-20). "Treating prolonged grief disorder with prolonged grief-specific cognitive behavioral therapy: study protocol for a randomized controlled trial". Trials. 19 (1): 241. doi: 10.1186/s13063-018-2618-3 . ISSN   1745-6215. PMC   5910599 . PMID   29678193.
  10. ↑ Silverman GK, Jacobs SC, Kasl SV, Shear MK, Maciejewski PK, Noaghiul FS, Prigerson HG (July 2000). "Quality of life impairments associated with diagnostic criteria for traumatic grief". Psychological Medicine. 30 (4): 857–62. doi:10.1017/S0033291799002524. PMID   11037094. S2CID   25793130.
  11. 1 2 Irwin M, Daniels M, Weiner H (1987). "Immune and neuroendocrine changes during bereavement". Psychiatr Clin North Am. 10 (3): 449–465. doi:10.1016/S0193-953X(18)30554-9. PMID   3317313.
  12. ↑ Males, Mike (September 1991). "Teen Suicide and Changing Cause-of-Death Certification, 1953-1987". Suicide and Life-Threatening Behavior. 21 (3): 245–258. doi:10.1111/j.1943-278x.1991.tb00948.x. ISSN   0363-0234. PMID   1759298.
  13. 1 2 3 4 Tal Young, I.; Iglewicz, A.; Glorioso, D.; Lanouette, N.; Seay, K.; Ilapakurti, M.; Zisook, S. (June 2012). "Suicide bereavement and complicated grief". Bereavement and Complicated Grief. 14 (2): 177–186. doi:10.31887/dcns.2012.14.2/iyoung. ISSN   2608-3477. PMC   3384446 . PMID   22754290.
  14. ↑ Szuhany, Kristin L.; Malgaroli, Matteo; Miron, Carly D.; Simon, Naomi M. (June 2021). "Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment". FOCUS. 19 (2): 161–172. doi:10.1176/appi.focus.20200052. ISSN   1541-4094. PMC   8475918 . PMID   34690579.
  15. 1 2 Frances, A. (2012, February 28). When Good Grief Goes Bad. The Huffington Post. Retrieved from http://www.huffingtonpost.com/allen-frances/grief-depression_b_1301050.html
  16. 1 2 Prigerson HG, Frank E, Kasl SV, Reynolds CF, Anderson B, Zubenko GS, et al. (January 1995). "Complicated grief and bereavement-related depression as distinct disorders: preliminary empirical validation in elderly bereaved spouses". The American Journal of Psychiatry. 152 (1): 22–30. CiteSeerX   10.1.1.466.8151 . doi:10.1176/ajp.152.1.22. PMID   7802116.
  17. ↑ Prigerson, Holly G.; Boelen, Paul A.; Xu, Jiehui; Smith, Kirsten V.; Maciejewski, Paul K. (2021-01-12). "Validation of the new DSM‐5‐TR criteria for prolonged grief disorder and the PG‐13‐Revised (PG‐13‐R) scale". World Psychiatry. 20 (1): 96–106. doi:10.1002/wps.20823. ISSN   1723-8617. PMC   7801836 . PMID   33432758. S2CID   231579446.
  18. 1 2 Diagnostic and statistical manual of mental disorders : DSM-5-TR. American Psychiatric Association (Fifth edition, text revision ed.). Washington, DC. 2022. ISBN   978-0-89042-575-6. OCLC   1288423302.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: others (link)
  19. ↑ "ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 2022-05-15.
  20. ↑ Prigerson HG, Maciejewski PK, Reynolds CF, Bierhals AJ, Newsom JT, Fasiczka A, et al. (November 1995). "Inventory of Complicated Grief: a scale to measure maladaptive symptoms of loss". Psychiatry Research. 59 (1–2): 65–79. doi:10.1016/0165-1781(95)02757-2. PMID   8771222. S2CID   34298459.
  21. 1 2 Kustanti, Christina Yeni; Chu, Hsin; Kang, Xiao Linda; Liu, Doresses; Pien, Li-Chung; Jen, Hsiu-Ju; Shen, Shu-Tai H.; Chen, Jin-Hua; Chou, Kuei-Ru (August 2021). "Evaluation of the performance of instruments to diagnose grief disorders: A diagnostic meta-analysis". International Journal of Nursing Studies. 120: 103972. doi:10.1016/j.ijnurstu.2021.103972. ISSN   0020-7489. PMID   34098452. S2CID   235370943.
  22. ↑ Boelen, Paul A.; Smid, Geert E. (2017-01-27). "The Traumatic Grief Inventory Self-Report Version (TGI-SR): Introduction and Preliminary Psychometric Evaluation". Journal of Loss and Trauma. 22 (3): 196–212. doi: 10.1080/15325024.2017.1284488 . ISSN   1532-5024. S2CID   151537220.
  23. 1 2 3 Heeke, Carina; Kampisiou, Christina; Niemeyer, Helen; Knaevelsrud, Christine (2017-12-29). "A systematic review and meta-analysis of correlates of prolonged grief disorder in adults exposed to violent loss". European Journal of Psychotraumatology. 8 (sup6): 1583524. doi:10.1080/20008198.2019.1583524. ISSN   2000-8198. PMC   6442112 . PMID   30949303.
  24. ↑ Wright AA, Keating NL, Balboni TA, Matulonis UA, Block SD, Prigerson HG (October 2010). "Place of death: correlations with quality of life of patients with cancer and predictors of bereaved caregivers' mental health". Journal of Clinical Oncology. 28 (29): 4457–64. doi:10.1200/JCO.2009.26.3863. PMC   2988637 . PMID   20837950.
  25. ↑ Kersting A, Wagner B (June 2012). "Complicated grief after perinatal loss". Dialogues in Clinical Neuroscience. 14 (2): 187–94. doi:10.31887/DCNS.2012.14.2/akersting. PMC   3384447 . PMID   22754291.
  26. ↑ Barry LC, Kasl SV, Prigerson HG (2002). "Psychiatric disorders among bereaved persons: the role of perceived circumstances of death and preparedness for death". The American Journal of Geriatric Psychiatry. 10 (4): 447–57. doi:10.1176/appi.ajgp.10.4.447. PMID   12095904.
  27. ↑ Hebert RS, Dang Q, Schulz R (June 2006). "Preparedness for the death of a loved one and mental health in bereaved caregivers of patients with dementia: findings from the REACH study". Journal of Palliative Medicine. 9 (3): 683–93. doi:10.1089/jpm.2006.9.683. PMID   16752974.
  28. 1 2 Vanderwerker LC, Jacobs SC, Parkes CM, Prigerson HG (February 2006). "An exploration of associations between separation anxiety in childhood and complicated grief in later life". The Journal of Nervous and Mental Disease. 194 (2): 121–3. doi:10.1097/01.nmd.0000198146.28182.d5. PMID   16477190. S2CID   8995920.
  29. ↑ Johnson JG, Zhang B, Greer JA, Prigerson HG (January 2007). "Parental control, partner dependency, and complicated grief among widowed adults in the community". The Journal of Nervous and Mental Disease. 195 (1): 26–30. doi:10.1097/01.nmd.0000252009.45915.b2. PMID   17220736. S2CID   45358849.
  30. ↑ Silverman GK, Johnson JG, Prigerson HG (2001). "Preliminary explorations of the effects of prior trauma and loss on risk for psychiatric disorders in recently widowed people". The Israel Journal of Psychiatry and Related Sciences. 38 (3–4): 202–15. PMID   11725418.
  31. ↑ Mitchell AM, Kim Y, Prigerson HG, Mortimer-Stephens M (2004). "Complicated grief in survivors of suicide". Crisis. 25 (1): 12–8. doi:10.1027/0227-5910.25.1.12. PMID   15384652.
  32. ↑ van Doorn C, Kasl SV, Beery LC, Jacobs SC, Prigerson HG (September 1998). "The influence of marital quality and attachment styles on traumatic grief and depressive symptoms". The Journal of Nervous and Mental Disease. 186 (9): 566–73. doi:10.1097/00005053-199809000-00008. PMID   9741563.
  33. ↑ Sekowski, M; Prigerson, HG (2022). "Disorganized attachment and prolonged grief". Journal of Clinical Psychology. 78 (9): 1806–1823. doi:10.1002/jclp.23325. ISSN   0021-9762.
  34. ↑ Sekowski, M.; Prigerson, H. G. (2021-07-01). "Associations between interpersonal dependency and severity of prolonged grief disorder symptoms in bereaved surviving family members". Comprehensive Psychiatry. 108: 152242. doi: 10.1016/j.comppsych.2021.152242 . ISSN   0010-440X. PMID   33979631. S2CID   234486311.
  35. ↑ Sekowski, M.; Prigerson, H. G. (2021). "Conflicted or close: Which relationships to the deceased are associated with loss-related psychopathology?". British Journal of Clinical Psychology. 61 (2): 510–526. doi:10.1111/bjc.12344. ISSN   2044-8260. PMID   34724233. S2CID   240422216.
  36. 1 2 McDermott OD, Prigerson HG, Reynolds CF, Houck PR, Dew MA, Hall M, et al. (March 1997). "Sleep in the wake of complicated grief symptoms: an exploratory study". Biological Psychiatry. 41 (6): 710–6. doi:10.1016/S0006-3223(96)00118-7. PMID   9066995. S2CID   22306103.
  37. ↑ O'Connor MF, Wellisch DK, Stanton AL, Eisenberger NI, Irwin MR, Lieberman MD (August 2008). "Craving love? Enduring grief activates brain's reward center". NeuroImage. 42 (2): 969–72. doi:10.1016/j.neuroimage.2008.04.256. PMC   2553561 . PMID   18559294.
  38. ↑ Reynolds CF, Miller MD, Pasternak RE, Frank E, Perel JM, Cornes C, et al. (February 1999). "Treatment of bereavement-related major depressive episodes in later life: a controlled study of acute and continuation treatment with nortriptyline and interpersonal psychotherapy". The American Journal of Psychiatry. 156 (2): 202–8. doi:10.1176/ajp.156.2.202. PMID   9989555. S2CID   46097175.
  39. ↑ Pasternak RE, Reynolds CF, Schlernitzauer M, Hoch CC, Buysse DJ, Houck PR, Perel JM (July 1991). "Acute open-trial nortriptyline therapy of bereavement-related depression in late life". The Journal of Clinical Psychiatry. 52 (7): 307–10. PMID   2071562.
  40. ↑ Shear K, Frank E, Houck PR, Reynolds CF (June 2005). "Treatment of complicated grief: a randomized controlled trial". JAMA. 293 (21): 2601–8. doi:10.1001/jama.293.21.2601. PMC   5953417 . PMID   15928281.
  41. ↑ Boelen PA, de Keijser J, van den Hout MA, van den Bout J (April 2007). "Treatment of complicated grief: a comparison between cognitive-behavioral therapy and supportive counseling". Journal of Consulting and Clinical Psychology. 75 (2): 277–84. doi:10.1037/0022-006X.75.2.277. PMID   17469885.
  42. ↑ Eddinger, Jasmine R.; Hardt, Madeleine M.; Williams, Joah L. (2019-06-13). "Concurrent Treatment for PTSD and Prolonged Grief Disorder: Review of Outcomes for Exposure- and Nonexposure-Based Treatments". OMEGA - Journal of Death and Dying. 83 (3): 446–469. doi:10.1177/0030222819854907. ISSN   0030-2228. PMID   31194639. S2CID   189813903.
  43. ↑ Boelen, Paul; Lenferink, Lonneke (2020). "Comparison of six proposed diagnostic criteria sets for disturbed grief". Psychiatry Research. 285: 112786. doi:10.1016/j.psychres.2020.112786. PMID   32000105. S2CID   210928314.
  44. 1 2 3 4 Djelantik, A.A.A. Manik J.; Smid, Geert E.; Mroz, Anna; Kleber, Rolf J.; Boelen, Paul A. (March 2020). "The prevalence of prolonged grief disorder in bereaved individuals following unnatural losses: Systematic review and meta regression analysis". Journal of Affective Disorders. 265: 146–156. doi:10.1016/j.jad.2020.01.034. ISSN   0165-0327. PMID   32090736. S2CID   211262942.
  45. ↑ Tal, Ilanit; Mauro, Christine; Reynolds, Charles F.; Shear, M. Katherine; Simon, Naomi; Lebowitz, Barry; Skritskaya, Natalia; Wang, Yuanjia; Qiu, Xin; Iglewicz, Alana; Glorioso, Danielle (2016-11-28). "Complicated grief after suicide bereavement and other causes of death". Death Studies. 41 (5): 267–275. doi:10.1080/07481187.2016.1265028. ISSN   0748-1187. PMID   27892842. S2CID   205585458.
  46. ↑ Komischke-Konnerup, Katrine B.; Zachariae, Robert; Johannsen, Maja; Nielsen, Louise Dyrvig; O'Connor, Maja (April 2021). "Co-occurrence of prolonged grief symptoms and symptoms of depression, anxiety, and posttraumatic stress in bereaved adults: A systematic review and meta-analysis". Journal of Affective Disorders Reports. 4: 100140. doi: 10.1016/j.jadr.2021.100140 . ISSN   2666-9153. S2CID   233565546.
  47. ↑ American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). Washington: American Psychiatric Press. ISBN   978-0-89042-062-1.[ page needed ]
  48. ↑ National Center for Health Statistics (2009) International Classification of Diseases, Tenth Revision (ICD-10).; Available at: CDC. Accessed 12 July 2012.
  49. ↑ Boelen PA, Prigerson HG (October 2012). "Commentary on the inclusion of persistent complex bereavement-related disorder in DSM-5". Death Studies. 36 (9): 771–94. doi:10.1080/07481187.2012.706982. PMID   24563927. S2CID   44547916.
  50. ↑ Kilikelly, Clare; Zhou, Ningning; Merzhvynska, Mariia; Stelzer, Eva-Maria; Dotschung, Tenzin; Rohner, Stefan; Sun, Lea Han; Maercker, Andreas (2020). "Development of the International Prolonged Grief Disorder Scale for the ICD-11: measurement of core symptoms and culture items adapted for Chinese and German-speaking samples". Journal of Affective Disorders. 277: 568–576. doi: 10.1016/j.jad.2020.08.057 . PMID   32896722.
  51. ↑ Prigerson HG, Shear MK, Jacobs SC, Reynolds CF, Maciejewski PK, Davidson JR, et al. (January 1999). "Consensus criteria for traumatic grief. A preliminary empirical test". The British Journal of Psychiatry. 174: 67–73. doi:10.1192/bjp.174.1.67. PMID   10211154. S2CID   19235992.
  52. ↑ Rodríguez Villar S, Sánchez Casado M, Prigerson HG, Mesa García S, Rodríguez Villar M, Hortigüela Martín VA, et al. (June 2012). "Prolonged grief disorder in the next of kin of adult patients who die during or after admission to intensive care". Chest. 141 (6): 1635–1636. doi: 10.1378/chest.11-3099 . PMID   22670028.
  53. ↑ Morina N, von Lersner U, Prigerson HG (2011). Laks J (ed.). "War and bereavement: consequences for mental and physical distress". PLOS ONE. 6 (7): e22140. Bibcode:2011PLoSO...622140M. doi: 10.1371/journal.pone.0022140 . PMC   3134481 . PMID   21765944.
  54. ↑ Mitchell, Ann M.; Kim, Yookyung; Prigerson, Holly G.; Mortimer-Stephens, MaryKay (January 2004). "Complicated Grief in Survivors of Suicide". Crisis. 25 (1): 12–18. doi:10.1027/0227-5910.25.1.12. ISSN   0227-5910. PMID   15384652.
  55. ↑ Reed, Geoffrey M.; First, Michael B.; Billieux, Joël; Cloitre, Marylene; Briken, Peer; Achab, Sophia; Brewin, Chris R.; King, Daniel L.; Kraus, Shane W.; Bryant, Richard A. (2022-05-07). "Emerging experience with selected new categories in the ICD‐11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder". World Psychiatry. 21 (2): 189–213. doi:10.1002/wps.20960. ISSN   1723-8617. PMC   9077619 . PMID   35524599.
  56. ↑ Johnson JG, First MB, Block S, Vanderwerker LC, Zivin K, Zhang B, Prigerson HG (September 2009). "Stigmatization and receptivity to mental health services among recently bereaved adults". Death Studies. 33 (8): 691–711. doi:10.1080/07481180903070392. PMC   2834798 . PMID   19697482.
  57. ↑ Gonschor, Judith; Eisma, Maarten; Barke, Antonia; Doering, Bettina (2020). "Public stigma towards prolonged grief disorder: Does diagnostic labeling matter?". PLOS ONE. 15 (9): e0237021. Bibcode:2020PLoSO..1537021G. doi: 10.1371/journal.pone.0237021 . PMC   7485774 . PMID   32915800.
  58. 1 2 Feigelman, William; Gorman, Bernard S.; Jordan, John R. (2009-07-10). "Stigmatization and Suicide Bereavement". Death Studies. 33 (7): 591–608. doi:10.1080/07481180902979973. ISSN   0748-1187. PMID   19623760. S2CID   29662441.
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