Prevalence, Factor Structure and Correlates of DSM-5-TR Criteria for Prolonged Grief Disorder

Julia Treml; Elmar Brähler; Anette Kersting

doi:10.3389/fpsyt.2022.880380

Prevalence, Factor Structure and Correlates of DSM-5-TR Criteria for Prolonged Grief Disorder

Front Psychiatry. 2022 May 18:13:880380. doi: 10.3389/fpsyt.2022.880380. eCollection 2022.

Authors

Julia Treml¹, Elmar Brähler^{2

3}, Anette Kersting¹

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany.
² Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
³ Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany.

Abstract

Background: Prolonged Grief Disorder (PGD) is now included in Section II of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR). To understand the health burden and then allocate economic and professional resources, it is necessary to provide epidemiological data for this new disorder. This is especially relevant since the new diagnostic criteria differ from its predecessors, which may affect the generalizability of previous findings. More information on the characteristics of people suffering from PGD is also beneficial to better identify individuals at risk. This study, therefore, aimed to estimate the prevalence of the new PGD criteria in a representative population-based sample, evaluate the factor structure, sociodemographic, and loss-related correlates of PGD caseness and explore possible predictors.

Methods: Out of a representative sample of the German general population (N = 2,531), n = 1,371 (54.2%) reported to have experienced a significant loss throughout lifetime. Participants provided sociodemographic data and loss-related characteristics. PGD symptoms were measured using items from the German versions of the Prolonged Grief Scale (PG-13) and the Inventory of Complicated Grief (ICG), which could be matched to the DSM-5-TR criteria for PGD.

Results: The conditional prevalence of PGD was 3.4% (n = 47). The most frequently reported symptoms were intense emotional pain and intense yearning or longing for the deceased. The confirmatory factor analysis confirmed a unidimensional model of PGD. Regression analysis demonstrated that time since the death, the relationship to the deceased, and unpreparedness for the death were significant predictors of PGD.

Conclusion: Although the prevalence of 3.4% using the new diagnostic criteria is lower than the prevalence previously suggested by a meta-analysis, PGD remains a substantial disorder in the general population. In particular, the loss of a partner or child increases the risk for PGD, as does unpreparedness for the death of a loved one. Clinicians should pay particular attention to these high-risk groups. Further clinical implications are discussed.

Keywords: DSM-5-TR; bereavement; grief/loss; prevalence; prolonged grief disorder (PGD).