Comparison of six proposed diagnostic criteria sets for disturbed grief

Increased recognition that grief may turn into a disorder led to the inclusion of Persistent Complex Bereavement Disorder (PCBD) in DSM-5 and Prolonged Grief Disorder (PGD) in ICD-11. Four additional criteria sets for disturbed grief have been proposed in recent years: Prigerson et al. proposed criteria for PGD (“PGD-2009″), Maercker et al. presented an ICD-11 beta draft version of PGD (“PGD-BD”), Shear et al. put forth criteria for complicated grief (“CG”), and, recently, criteria for PGD in DSM-5-TR have been proposed. This study sought to evaluate these six sets in one sample, which has not been done before. Using self-reported data from 855 bereaved individuals, we examined the (i) dimensionality, (ii) number of possible symptom combinations to meet criteria for caseness, (iii) prevalence rates and diagnostic agreement, (iv) concurrent validity, and (v) socio-demographic and loss-related correlates for each set. Criteria for PCBD were best represented by a three-factor structure and CG by a two-factor structure. Symptoms of ICD-11 PGD, PGD-2009, PGD-BD, and PGD-DSM-5-TR formed a single dimension. Prevalence rates varied between ~10% and ~20%. Diagnostic agreement between sets was substantial. Sets differed in terms of possible symptom combinations and had comparable concurrent validity and socio-demographic and loss-related correlates.

Highlights
 
•  This is the first study testing performance of six criteria sets for disturbed grief.
•  Diagnostic performance of DSM-5-TR prolonged grief disorder was also tested.
•  Prevalence rates varied between ~10% and ~20% across six grief disorders.
•  The grief disorders differed in terms of possible symptom combinations.
•  The grief disorders had comparable concurrent validity.
 


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Reference: 
Paul A. Boelen, Lonneke I.M. Lenferink | 2020
In: Psychiatry Research ISSN: 0165-1781 | 285 | maart | 112786
https://doi.org/10.1016/j.psychres.2020.112786
Keywords: 
Bereavement, Diagnosis, Netherlands, Prolonged Grief Disorder, PTSD (DSM-5), PTSD (ICD-11), Traumatic Grief