Disclosures: Healio Psychiatry was unable to confirm relevant financial disclosures at time of reporting.
February 12, 2021
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Prolonged grief disorder scales appear reliable, valid

Disclosures: Healio Psychiatry was unable to confirm relevant financial disclosures at time of reporting.
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Researchers have validated two scales for prolonged grief disorder, according to study results published in World Psychiatry.

“Many people wonder how to distinguish pathological grief from normal grief, major depressive disorder and PTSD, and how the name and symptoms of this disorder can be reconciled given a number of different formulations over the years,” Holly G. Prigerson, PhD, director of the Cornell Center for Research on End-of-Life Care at Weill Cornell Medicine, told Healio Psychiatry. “This research may not be the final word on the matter, but it does help to resolve confusion while offering clarity, consensus, and validation of the defining features of Prolonged Grief Disorder. Specifically, it uses data from three independent cohort studies of bereaved individuals — one study from Yale, one from Oxford and one from Utrecht — to validate the new DSM-5-TR criteria for prolonged grief disorder.”

woman looking sad being comforted
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Holly G. Prigerson

Prigerson and colleagues also aimed to provide psychometric testing of the Prolonged Grief-Revised (PG-13-R) scale, which maps on the DSM-5-TR. They analyzed data of 672 total participants of the three cohort studies. Data were available for baseline assessments at 12 to 24 months post-loss, with follow-up assessment having taken place 5.3 to 12 months later.

Results showed a unidimensional construct, with high degrees of internal consistency, for the PG-13-R grief symptoms. Further, diagnosis of prolonged grief disorder according to the DSM appeared distinct from PTSD, MDD and generalized anxiety disorder. The researchers noted “remarkable” temporal stability for this diagnosis. Across the datasets, kappa agreement between a PG-13-R threshold symptom summary score of 30 and the DSM symptom criterion for prolonged grief disorder was 0.7-0.89. Prigerson and colleagues observe a significant association between both the DSM prolonged grief disorder diagnosis and the PG-13-R symptom summary score at baseline and symptoms and diagnoses of MDD, PTSD and/or generalized anxiety disorder, suicidal ideation, worse quality of life and functional impairments at baseline and at follow-up in the three datasets.

“[These findings] provide answers to the questions: What is prolonged grief disorder and its symptoms and diagnostic criteria? What score on the PG-13-R can be used to determine who has a likely case of prolonged grief disorder?” Prigerson said. “It also provides validation of the DSM-5-TR criteria and the PG-13-R to assess it so clinicians can use a reliable and validated metric for diagnosing, billing and monitoring the efficacy of treatment.”