Comparison of proposed diagnostic criteria for pathological grief using a sample of elderly bereaved spouses in Denmark: Perspectives on future bereavement research.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 05 2019
Historique:
received: 27 11 2018
revised: 12 01 2019
accepted: 22 01 2019
pubmed: 25 3 2019
medline: 13 7 2019
entrez: 24 3 2019
Statut: ppublish

Résumé

A distinct grief-specific disorder is included in the ICD-11. Lack of clarity remains regarding whether different proposed diagnostic criteria capture similar or different diagnostic entities. Our aim was to examine the specificity of four proposed diagnostic criteria-sets for pathological grief in a population-based sample. Participants were 206 conjugally bereaved elderly Danes (59% female; mean age = 72.5 years, SD = 4.2; range 65-81) who completed self-report questionnaires six months post-loss. The main measure was the Danish version of Inventory of Complicated Grief-Revised. Results indicate substantial agreement between Prolonged Grief Disorder (PGD), Persistent Complex Bereavement Disorder (PCBD) and ICD-11-PGD (kappa's = 0.69-0.84), which found 6-9% of cases tested positive for pathological grief. Complicated Grief (CG) was partly in agreement with the three other symptom-diagnostic tests (kappa's = 0.13-0.20), and the prevalence-rate of pathological grief was 48%. The low response-rate of 39%. The selective inclusion of data ≥6 months post-loss prevents a comparison of acute and prolonged grief reactions. Using self-reported data, not diagnostic interviews, challenges the validity of our findings. Using a sample of elderly people may limit the generalizability of our results to other age groups. We suggest that PGD, PCBD and ICD-11-PGD may be more discriminative in identifying a specific grief-related psychopathology, while CG may identify a broader set of grief reactions.

Sections du résumé

BACKGROUND
A distinct grief-specific disorder is included in the ICD-11. Lack of clarity remains regarding whether different proposed diagnostic criteria capture similar or different diagnostic entities. Our aim was to examine the specificity of four proposed diagnostic criteria-sets for pathological grief in a population-based sample.
METHODS
Participants were 206 conjugally bereaved elderly Danes (59% female; mean age = 72.5 years, SD = 4.2; range 65-81) who completed self-report questionnaires six months post-loss. The main measure was the Danish version of Inventory of Complicated Grief-Revised.
RESULTS
Results indicate substantial agreement between Prolonged Grief Disorder (PGD), Persistent Complex Bereavement Disorder (PCBD) and ICD-11-PGD (kappa's = 0.69-0.84), which found 6-9% of cases tested positive for pathological grief. Complicated Grief (CG) was partly in agreement with the three other symptom-diagnostic tests (kappa's = 0.13-0.20), and the prevalence-rate of pathological grief was 48%.
LIMITATIONS
The low response-rate of 39%. The selective inclusion of data ≥6 months post-loss prevents a comparison of acute and prolonged grief reactions. Using self-reported data, not diagnostic interviews, challenges the validity of our findings. Using a sample of elderly people may limit the generalizability of our results to other age groups.
CONCLUSION
We suggest that PGD, PCBD and ICD-11-PGD may be more discriminative in identifying a specific grief-related psychopathology, while CG may identify a broader set of grief reactions.

Identifiants

pubmed: 30903989
pii: S0165-0327(18)32998-7
doi: 10.1016/j.jad.2019.01.056
pii:
doi:

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

52-59

Informations de copyright

Copyright © 2019. Published by Elsevier B.V.

Auteurs

Maja O'Connor (M)

Unit for Bereavement Research, Department of Psychology, Aarhus University, Aarhus, Denmark; The Danish National Center for Grief, Copenhagen, Denmark. Electronic address: maja@psy.au.dk.

Mathias Lasgaard (M)

DEFACTUM, Central Denmark Region, Aarhus, Denmark.

Lene Larsen (L)

The Danish National Center for Grief, Copenhagen, Denmark.

Maja Johannsen (M)

Unit for Bereavement Research, Department of Psychology, Aarhus University, Aarhus, Denmark.

Marie Lundorff (M)

Unit for Bereavement Research, Department of Psychology, Aarhus University, Aarhus, Denmark.

Ingeborg Farver-Vestergaard (I)

Unit for Bereavement Research, Department of Psychology, Aarhus University, Aarhus, Denmark.

Paul A Boelen (PA)

Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Arq Psychotrauma Expert Group, Diemen, the Netherlands.

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