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BMC Psychiatry
Published in: BMC Psychiatry 1/2024

Open Access 01-12-2024 | Research

Prolonged grief disorder in an inpatient psychiatric sample: psychometric properties of a new clinical interview and preliminary prevalence

Authors: Mirjam Sophie Rueger, Franziska Lechner-Meichsner, Lotte Kirschbaum, Silke Lubik, Sibylle C. Roll, Regina Steil

Published in: BMC Psychiatry | Issue 1/2024

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Abstract

Background

Prolonged Grief Disorder (PGD) was newly included in the ICD-11 and DSM-5-TR. It is not yet part of the standard assessments in many healthcare systems, including psychiatric wards. Because disordered grief is associated with suicidality, sleep problems and substance use disorders, an investigation into PGD in psychiatric inpatients is warranted.

Method

We interviewed N = 101 psychiatric inpatients who were admitted to the open psychiatric wards and the day hospital of a German psychiatric hospital and who had lost a person close to them. Assessments comprised clinical interviews and self-report instruments covering PGD and other mental disorders. We specifically developed the International Interview for Prolonged Grief Disorder according to ICD-11 (I-PGD-11) for the study and examined its psychometric properties.

Results

The prevalence rate of PGD among bereaved patients according to ICD-11 was 16.83% and according to DSM-5-TR 10.89%. The I-PGD-11 showed good psychometric properties (Mc Donald’s ω = 0.89, ICC = 0.985). Being female, having lost a child or spouse, and unnatural or surprising circumstances of the death were associated with higher PGD scores.

Trial registration

Approval was obtained by the ethics committee of the of the Goethe University Frankfurt (2021-62, 2023-17) and the Chamber of Hessian Physicians (2021-2730-evBO). The study was preregistered (https://​doi.​org/​10.​17605/​OSF.​IO/​K98MF).

Limitations

We only assessed inpatients of one psychiatric clinic in Germany, limiting the generalizability of our findings.

Conclusion

The present study underlines the importance of exploring loss and grief in psychiatric inpatients and including PGD in the assessments. Given that a significant minority of psychiatric inpatients has prolonged grief symptoms, more research into inpatient treatment programs is needed.
Appendix
Available only for authorised users
Footnotes
1
varisano Klinikum Frankfurt Höchst, Klinik für psychische Gesundheit.
 
Literature
1.
World Health Organization. ICD-11. Int Classif Dis 11th Revis. 2018.
2.
APA. Diagnostic and statistical manual of mental disorders: DSM-5-TR. Fifth edition, text revision. Washington, DC: American Psychiatric Association Publishing; 2022. (DSM-5-TR).
3.
Prigerson HG, Kakarala S, Gang J, Maciejewski PK. History and status of prolonged grief disorder as a Psychiatric diagnosis. Annu Rev Clin Psychol 7 Mai. 2021;17(1):109–26.CrossRef
4.
Boelen PA, Lenferink LIM. Comparison of six proposed diagnostic criteria sets for disturbed grief. Psychiatry Res. 2020;285:112786.PubMedCrossRef
5.
Maciejewski PK, Maercker A, Boelen PA, Prigerson HG. Prolonged grief disorder’ and ’persistent complex bereavement disorder’, but not ’complicated grief’, are one and the same diagnostic entity: an analysis of data from the Yale Bereavement Study. World Psychiatry Januar. 2016;15(3):266–532.CrossRef
6.
Killikelly C, Zhou N, Merzhvynska M, Stelzer EM, Dotschung T, Rohner S. u. a. development of the international prolonged grief disorder scale for the ICD-11: measurement of core symptoms and culture items adapted for Chinese and german-speaking samples. J Affect Disord. 2020;277:568–76.PubMedCrossRef
7.
Eisma MC, Rosner R, Comtesse H. ICD-11 prolonged grief disorder criteria: turning challenges into opportunities with multiverse analyses. Front Psychiatry Januar. 2020;11:752–1504.CrossRef
8.
Andrews B, Hejdenberg J, Wilding J. Student anxiety and depression: comparison of questionnaire and interview assessments. J Affect Disord. 2006;95(1):29–34.PubMedCrossRef
9.
Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 1 Dezember. 1994;16(4):363–70.CrossRef
10.
Goodman A, Heiervang E, Fleitlich-Bilyk B, Alyahri A, Patel V, Mullick MSI. u. a. cross-national differences in questionnaires do not necessarily reflect comparable differences in disorder prevalence. Soc Psychiatry Psychiatr Epidemiol 1 August. 2012;47(8):1321–31.CrossRef
11.
Hopwood CJ, Morey LC, Edelen MO, Shea MT, Grilo CM, Sanislow CA. u. a. A comparison of interview and self-report methods for the assessment of borderline personality disorder criteria. Psychol Assess März. 2008;20(1):81–162.CrossRef
12.
Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of Depression in the community from 30 countries between 1994 and 2014. Sci Rep 12 Februar. 2018;8(1):2861.CrossRef
13.
Marta-Pedroso C, Freitas H, Domingos T. Testing for the survey mode effect on contingent valuation data quality: a case study of web based versus in-person interviews. Ecol Econ 15 Mai. 2007;62(3):388–98.CrossRef
14.
Kramer LB, Whiteman SE, Petri JM, Spitzer EG, Weathers FW. Self-rated versus clinician-rated assessment of posttraumatic stress disorder: an evaluation of discrepancies between the PTSD checklist for DSM-5 and the clinician-administered PTSD scale for DSM-5. Assessment. 2023;30(5):1590–605.PubMedCrossRef
15.
Lenferink LIM, Franzen M, ten Klooster PM, Knaevelsrud C, Boelen PA, Heeke C. The traumatic grief inventory-clinician administered: a psychometric evaluation of a new interview for ICD-11 and DSM-5-TR prolonged grief disorder severity and probable caseness. J Affect Disord Juni. 2023;330:188–376.CrossRef
16.
Boelen PA, Smid GE. The traumatic grief Inventory Self-Report Version (TGI-SR): introduction and preliminary psychometric evaluation. J Loss Trauma 3 April. 2017;22(3):196–212.CrossRef
17.
Lenferink LIM, Eisma MC, Smid GE, de Keijser J, Boelen PA. Valid measurement of DSM-5 persistent complex bereavement disorder and DSM-5-TR and ICD-11 prolonged grief disorder: the traumatic grief inventory-self Report Plus (TGI-SR+). Compr Psychiatry 1 Januar. 2022;112:152281.CrossRef
18.
Prigerson HG, Boelen PA, Xu J, Smith KV, Maciejewski PK. Validation of the new DSM-5‐TR criteria for prolonged grief disorder and the PG‐13‐Revised (PG‐13‐R) scale. World Psychiatry Januar. 2021;20(1):96–192.CrossRef
19.
Rosner R, Comtesse H, Vogel A, Doering BK. Prevalence of prolonged grief disorder. J Affect Disord Mai. 2021;287:301–602.CrossRef
20.
Killikelly C, Lorenz L, Bauer S, Mahat-Shamir M, Ben-Ezra M, Maercker A. Prolonged grief disorder: its co-occurrence with adjustment disorder and post-traumatic stress disorder in a bereaved Israeli general-population sample. J Affect Disord April. 2019;249:307–614.CrossRef
21.
Shevlin M, Redican E, Hyland P, Murphy J, Karatzias T, Mc Bride. O, u. a. symptoms and levels of ICD-11 prolonged grief disorder in a representative community sample of UK adults. Soc PSYCHIATRY Psychiatr Epidemiol; April 2023.
22.
Treml J, Brähler E, Kersting A, Prevalence. Factor structure and correlates of DSM-5-TR criteria for prolonged grief disorder. Front Psychiatry Mai 2022;13.
23.
Boelen PA, Lenferink LIM, Nickerson A, Smid GE. Evaluation of the factor structure, prevalence, and validity of disturbed grief in DSM-5 and ICD-11. J Affect Disord November. 2018;240:79–158.CrossRef
24.
Killikelly C, Merzhvynska M, Zhou N, Stelzer EM, Hyland P, Rocha J. u. a. examination of the new ICD-11 prolonged grief disorder guidelines across five international samples. Clin Psychol Eur Januar. 2021;3(1):e4159–0.CrossRef
25.
Killikelly C, Kagialis A, Henneman S, Coronado H, Demanarig D, Farahani H. u. a. measurement and assessment of grief in a large international sample. J Affect Disord April. 2023;327:306–612.CrossRef
26.
Boelen PA, Lenferink LIM. Prolonged grief disorder in DSM-5-TR: early predictors and longitudinal measurement invariance. Aust N Z J Psychiatry Juni. 2022;56(6):667–1334.CrossRef
27.
Haneveld J, Rosner R, Vogel A, Kersting A, Rief W, Steil R. u. a. same name, same content? Evaluation of DSM-5-TR and ICD-11 prolonged grief criteria. J Consult Clin Psychol April. 2022;90(4):303–606.CrossRef
28.
Bryant RA, Bawaneh A, Giardinelli L, Awwad M, Al-Hayek H, Akhtar A. A prevalence assessment of prolonged grief disorder in Syrian refugees. World Psychiatry Juni. 2021;20(2):302–604.CrossRef
29.
Zhou N, Wen J, Stelzer EM, Killikelly C, Yu W, Xu X. Prevalence and associated factors of prolonged grief disorder in Chinese parents bereaved by losing their only child. Psychiatry Res Februar 2020;284.
30.
Baumann I, Künzel J, Goldbeck L, Tutus D, Niemitz M. Prolonged grief, posttraumatic stress, and depression among bereaved parents: prevalence and response to an intervention program. Omega - J Death Dying Januar. 2022;84(3):837–1674.CrossRef
31.
Tang S, Xiang Z. Who suffered most after deaths due to COVID-19? Prevalence and correlates of prolonged grief disorder in COVID-19 related bereaved adults. Glob Health Februar. 2021;17(1):1–2.
32.
Gang J, Falzarano F, She WJ, Winoker H, Prigerson HG. Are deaths from COVID-19 associated with higher rates of prolonged grief disorder (PGD) than deaths from other causes? Death Stud Januar. 2022;46(6):1287–2574.CrossRef
33.
Buur C, Zachariae R, Komischke-Konnerup K, Marello M, Schierff L, O’Connor M. Risk factors for prolonged grief symptoms a systematic review and meta-analysis. Clin Psychol Rev. 2023;102375.
34.
Jordan AH, Litz BT. Prolonged grief disorder: diagnostic, assessment, and treatment considerations. Prof Psychol Res Pract. 2014;45(3):180.CrossRef
35.
Wittouck C, Van Autreve S, De Jaegere E, Portzky G, van Heeringen K. The prevention and treatment of complicated grief: a meta-analysis. Clin Psychol Rev Januar. 2011;31(1):69–138.CrossRef
36.
Caarls PJ, van Schijndel MA, Kromkamp M, Wierdsma AI, Osse RJ, van Hoeven G. Der, u. a. need analysis for a new high acuity medical psychiatry unit: which patients are considered for admission? BMC Health Serv Res Februar. 2019;19(1):1–2.
37.
Ziegenbein M, Anreis C, Brüggen B, Ohlmeier M, Kropp S. Januar. Possible criteria for inpatient psychiatric admissions: which patients are transferred from emergency services to inpatient psychiatric treatment? 2021.
38.
Carlson EB, Dalenberg C, Armstrong J, Daniels JW, Loewenstein R, Roth D. Multivariate prediction of posttraumatic symptoms in Psychiatric inpatients. J Trauma Stress 1 Juli. 2001;14(3):549–67.CrossRef
39.
Saba DK, Levit KR, Elixhauser A. Hospital stays related to mental health, 2006. Healthc Cost Util Proj HCUP Stat Briefs Internet; 2008.
40.
McFarlane AC, Bookless C, Air T. Posttraumatic Stress Disorder in a General Psychiatric Inpatient Population. J Trauma Stress 1 Oktober. 2001;14(4):633–45.CrossRef
41.
Pratt SI, Rosenberg S, Mueser KT, Brancato J, Salyers M, Jankowski MK. u. a. evaluation of a PTSD psychoeducational program for psychiatric inpatients. J Ment Health 1 April. 2005;14(2):121–7.CrossRef
42.
Szuhany KL, Malgaroli M, Miron CD, Simon NM. Prolonged grief disorder: Course, diagnosis, Assessment, and treatment. FOCUS 1 Juni. 2021;19(2):161–72.CrossRef
43.
44.
Margraf J, Cwik JC, Suppiger A, Schneider S. DIPS Open Access: diagnostic interview for Mental disorders. Bochum: Mental Health Research and Treatment Center, Ruhr-Universität Bochum; 2017.
45.
Margraf J, Cwik JC, Pflug V, Schneider S. Structured clinical interviews for mental disorders across the lifespan: psychometric quality and further developments of the DIPS Open Access interviews. Z Für Klin Psychol Psychother. 2017;(46):176–86.
46.
Derogatis LR. Brief Symptom Inventory (BSI), administration, scoring, and procedures manual. 3rd ed. National Computer Services; 1993.
47.
48.
49.
50.
Bernaards CA, Jennrich RI. Gradient Projection algorithms and Software for arbitrary rotation criteria in factor analysis. Educ Psychol Meas. 2005;65(5):676–96.CrossRef
51.
Kaiser HF. The application of electronic computers to factor analysis. Educ Psychol Meas. 1960;20(1):141–51.CrossRef
52.
Lê S, Josse J, Husson F, FactoMineR. A Package for Multivariate Analysis. J Stat Softw. 2008;25(1):1–18.CrossRef
53.
54.
55.
Hayes AF, Coutts JJ. Use Omega rather than Cronbach’s alpha for estimating reliability. Commun Methods Meas 2 Januar. 2020;14(1):1–24.CrossRef
56.
57.
Robin X, Turck N, Hainard A, Tiberti N, Lisacek F, Sanchez JC. u. a. pROC: an open-source package for R and S + to analyze and compare ROC curves. BMC Bioinformatics. 2011;12:77.PubMedPubMedCentralCrossRef
58.
Liaw A, Wiener M. Classification and regression by randomForest. R News. 2002;2(3):18–22.
59.
Zwick WR, Velicer WF. Comparison of five rules for determining the number of components to retain. Psychol Bull. 1986;99(3):432.CrossRef
60.
Cacciatore J, Frances A. Prolonged grief disorder – authors’ reply. Lancet Psychiatry 1 September. 2022;9(9):697.CrossRef
61.
Comtesse H, Vogel A, Kersting A, Rief W, Steil R, Rosner R. When does grief become pathological? Evaluation of the ICD-11 diagnostic proposal for prolonged grief in a treatment-seeking sample. Eur J Psychotraumatology Dezember 2020;11(1).
62.
Eisma MC. Prolonged grief disorder in ICD-11 and DSM-5-TR: challenges and controversies. Aust N Z J Psychiatry 1 Juli. 2023;57(7):944–51.CrossRef
63.
64.
Lundorff M, Holmgren H, Zachariae R, Farver-Vestergaard I, O’Connor M. Prevalence of prolonged grief disorder in adult bereavement: a systematic review and meta-analysis. J Affect Disord April. 2017;212:138–276.CrossRef
65.
Read J, Hammersley P, Rudegeair T. Why, when and how to ask about childhood abuse. Adv Psychiatr Treat Januar. 2007;13(2):101–202.CrossRef
66.
Sweeney A, Filson B, Kennedy A, Collinson L, Gillard S. A paradigm shift: relationships in trauma-informed mental health services. BJPsych Adv September. 2018;24(5):319–638.CrossRef
67.
Chapple A, Ziebland S, Hawton K. Taboo and the different death? Perceptions of those bereaved by suicide or other traumatic death. Sociol Health Illn. 2015;37(4):610–25.PubMedCrossRef
68.
Young J, Bailey G, Rycroft P. Family grief and mental health: a systemic, contextual and compassionate analysis. Aust N Z J Fam Ther. 2004;25(4):188–97.CrossRef
69.
Shear MK, Reynolds CFI, Simon NM, Zisook S, Wang Y, Mauro C. u. a. optimizing treatment of complicated grief: a randomized clinical trial. JAMA Psychiatry July. 2016;73(7):685–1370.CrossRef
70.
Rosner R, Lumbeck G, Geissner E. Effectiveness of an inpatient group therapy for comorbid complicated grief disorder. Psychother Res 1 März. 2011;21(2):210–8.CrossRef
71.
72.
Polit DF. Getting serious about test–retest reliability: a critique of retest research and some recommendations. Qual Life Res. 2014;23:1713–20.PubMedCrossRef
73.
McCrae RR, Kurtz JE, Yamagata S, Terracciano A. Internal consistency, retest reliability, and their implications for personality scale validity. Personal Soc Psychol Rev. 2011;15(1):28–50.CrossRef
Metadata
Title
Prolonged grief disorder in an inpatient psychiatric sample: psychometric properties of a new clinical interview and preliminary prevalence
Authors
Mirjam Sophie Rueger
Franziska Lechner-Meichsner
Lotte Kirschbaum
Silke Lubik
Sibylle C. Roll
Regina Steil
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2024
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-024-05784-2

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