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  • Title: Prolonged grief disorder in ICD-11 and DSM-5-TR: differences in prevalence and diagnostic criteria.
    Author: Treml J, Linde K, Brähler E, Kersting A.
    Journal: Front Psychiatry; 2024; 15():1266132. PubMed ID: 38389981.
    Abstract:
    BACKGROUND: Prolonged grief disorder (PGD) was recently included as a disorder in the ICD-11 and DSM-5-TR. Although both classification systems use the same name, the criteria content, and diagnostic approach vary. This study aimed to estimate the respective prevalence of PGDICD-11 and PGDDSM-5-TR and examine the diagnostic agreement while varying the diagnostic algorithm of PGDICD-11 (bereavement vs. symptom period; varying number of accessory symptoms). METHODS: A representative sample of the German general population (N = 2,509) was investigated, of which n=1,071 reported the loss of a close person. PGD symptoms were assessed with the Traumatic Grief Inventory - Self Report Plus (TGI-SR+). RESULTS: The point prevalence of PGD among the bereaved varied between 4.7%-6.8%, depending on the criteria and diagnostic algorithm. The prevalence of PGDDSM-5-TR was significantly lower than the prevalence of PGDICD-11. The diagnostic agreement between both criteria sets was substantial and increased after the number of accessory symptoms for PGDICD-11 was increased from one to three. The most common symptoms were intrusive thoughts/images related to the deceased person, longing for the deceased person, and difficulty accepting the loss. CONCLUSION: The results demonstrate that the prevalence of PGD significantly varies depending on the application of the diagnostic algorithm and criteria. PGD affects a substantial proportion of the general population and should be addressed by healthcare providers. However, applying the minimum ICD-11 criteria could lead overestimating the prevalence. Therefore, further harmonizing the ICD-11 and DSM-5-TR criteria and diagnostic algorithm for PGD seems appropriate.
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