Prolonged Grief Disorder in an Inpatient Psychiatric Sample: Psychometric Properties of a New Clinical Interview and Preliminary Prevalence

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2024 May 1

PMID 38693470

Authors

Mirjam Sophie Rueger

Franziska Lechner-Meichsner

Lotte Kirschbaum

Silke Lubik

Sibylle C Roll

Regina Steil

Affiliations

Soon will be listed here.

Abstract

Background: Prolonged Grief Disorder (PGD) was newly included in the ICD-11 and DSM-5-TR. It is not yet part of the standard assessments in many healthcare systems, including psychiatric wards. Because disordered grief is associated with suicidality, sleep problems and substance use disorders, an investigation into PGD in psychiatric inpatients is warranted.

Method: We interviewed N = 101 psychiatric inpatients who were admitted to the open psychiatric wards and the day hospital of a German psychiatric hospital and who had lost a person close to them. Assessments comprised clinical interviews and self-report instruments covering PGD and other mental disorders. We specifically developed the International Interview for Prolonged Grief Disorder according to ICD-11 (I-PGD-11) for the study and examined its psychometric properties.

Results: The prevalence rate of PGD among bereaved patients according to ICD-11 was 16.83% and according to DSM-5-TR 10.89%. The I-PGD-11 showed good psychometric properties (Mc Donald's ω = 0.89, ICC = 0.985). Being female, having lost a child or spouse, and unnatural or surprising circumstances of the death were associated with higher PGD scores.

Trial Registration: Approval was obtained by the ethics committee of the of the Goethe University Frankfurt (2021-62, 2023-17) and the Chamber of Hessian Physicians (2021-2730-evBO). The study was preregistered ( https://doi.org/10.17605/OSF.IO/K98MF ).

Limitations: We only assessed inpatients of one psychiatric clinic in Germany, limiting the generalizability of our findings.

Conclusion: The present study underlines the importance of exploring loss and grief in psychiatric inpatients and including PGD in the assessments. Given that a significant minority of psychiatric inpatients has prolonged grief symptoms, more research into inpatient treatment programs is needed.

References

Prigerson H, Boelen P, Xu J, Smith K, Maciejewski P . Validation of the new DSM-5-TR criteria for prolonged grief disorder and the PG-13-Revised (PG-13-R) scale. World Psychiatry. 2021; 20(1):96-106. PMC: 7801836. DOI: 10.1002/wps.20823. View

Zhou N, Wen J, Stelzer E, Killikelly C, Yu W, Xu X . Prevalence and associated factors of prolonged grief disorder in Chinese parents bereaved by losing their only child. Psychiatry Res. 2020; 284:112766. DOI: 10.1016/j.psychres.2020.112766. View

Rosner R, Comtesse H, Vogel A, Doering B . Prevalence of prolonged grief disorder. J Affect Disord. 2021; 287:301-307. DOI: 10.1016/j.jad.2021.03.058. View

Comtesse H, Vogel A, Kersting A, Rief W, Steil R, Rosner R . When does grief become pathological? Evaluation of the ICD-11 diagnostic proposal for prolonged grief in a treatment-seeking sample. Eur J Psychotraumatol. 2020; 11(1):1694348. PMC: 6968549. DOI: 10.1080/20008198.2019.1694348. View

Gang J, Falzarano F, She W, Winoker H, Prigerson H . Are deaths from COVID-19 associated with higher rates of prolonged grief disorder (PGD) than deaths from other causes?. Death Stud. 2022; 46(6):1287-1296. PMC: 9254485. DOI: 10.1080/07481187.2022.2039326. View

Buur C, Zachariae R, Komischke-Konnerup K, Marello M, Schierff L, OConnor M . Risk factors for prolonged grief symptoms: A systematic review and meta-analysis. Clin Psychol Rev. 2024; 107:102375. DOI: 10.1016/j.cpr.2023.102375. View

Killikelly C, Zhou N, Merzhvynska M, Stelzer E, Dotschung T, Rohner S . 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. J Affect Disord. 2020; 277:568-576. DOI: 10.1016/j.jad.2020.08.057. View

Shevlin M, Redican E, Hyland P, Murphy J, Karatzias T, McBride O . Symptoms and levels of ICD-11 Prolonged Grief Disorder in a representative community sample of UK adults. Soc Psychiatry Psychiatr Epidemiol. 2023; 58(10):1535-1547. PMC: 10098228. DOI: 10.1007/s00127-023-02469-1. View

Cacciatore J, Frances A . Prolonged grief disorder - Authors' reply. Lancet Psychiatry. 2022; 9(9):697. DOI: 10.1016/S2215-0366(22)00262-0. View

10.

Haneveld J, Rosner R, Vogel A, Kersting A, Rief W, Steil R . Same name, same content? Evaluation of DSM-5-TR and ICD-11 prolonged grief criteria. J Consult Clin Psychol. 2022; 90(4):303-313. DOI: 10.1037/ccp0000720. View

11.

Rosner R, Lumbeck G, Geissner E . Effectiveness of an inpatient group therapy for comorbid complicated grief disorder. Psychother Res. 2011; 21(2):210-8. DOI: 10.1080/10503307.2010.545839. View

12.

Fairburn C, Beglin S . Assessment of eating disorders: interview or self-report questionnaire?. Int J Eat Disord. 1994; 16(4):363-70. View

13.

Prigerson H, Kakarala S, Gang J, Maciejewski P . History and Status of Prolonged Grief Disorder as a Psychiatric Diagnosis. Annu Rev Clin Psychol. 2021; 17:109-126. DOI: 10.1146/annurev-clinpsy-081219-093600. View

14.

Bryant R, Bawaneh A, Giardinelli L, Awwad M, Al-Hayek H, Akhtar A . A prevalence assessment of prolonged grief disorder in Syrian refugees. World Psychiatry. 2021; 20(2):302-303. PMC: 8129832. DOI: 10.1002/wps.20876. View

15.

Killikelly C, Merzhvynska M, Zhou N, Stelzer E, Hyland P, Rocha J . Examination of the New ICD-11 Prolonged Grief Disorder Guidelines Across Five International Samples. Clin Psychol Eur. 2022; 3(1):e4159. PMC: 9667123. DOI: 10.32872/cpe.4159. View

16.

Boelen P, Lenferink L . Comparison of six proposed diagnostic criteria sets for disturbed grief. Psychiatry Res. 2020; 285:112786. DOI: 10.1016/j.psychres.2020.112786. View

17.

Eisma M . Prolonged grief disorder in ICD-11 and -5-TR: Challenges and controversies. Aust N Z J Psychiatry. 2023; 57(7):944-951. PMC: 10291380. DOI: 10.1177/00048674231154206. View

18.

Andrews B, Hejdenberg J, Wilding J . Student anxiety and depression: comparison of questionnaire and interview assessments. J Affect Disord. 2006; 95(1-3):29-34. DOI: 10.1016/j.jad.2006.05.003. View

19.

Zwick W, Velicer W . Factors Influencing Four Rules For Determining The Number Of Components To Retain. Multivariate Behav Res. 2016; 17(2):253-69. DOI: 10.1207/s15327906mbr1702_5. View

20.

Lim G, Tam W, Lu Y, Ho C, Zhang M, Ho R . Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Sci Rep. 2018; 8(1):2861. PMC: 5809481. DOI: 10.1038/s41598-018-21243-x. View