DEFINITION

• Prolonged grief disorder (PGD) is a persistent, incapacitating form of complicated grief.
  
  • Newly introduced as a formal diagnosis in ICD-11 in 2018 and DSM-5-TR in 2022. The duration threshold varies as PGD must last at least 12 months after the death based on the DSM-5-TR, but only 6 months based on the ICD-11.
• PGD is distinct from bereavement-related depression or anxiety and grief due to symptoms’ intensity and frequency: most of the day, nearly every day for at least 6-12+ months.
  • Most bereaved individuals eventually cope effectively with loss and do not experience adverse bereavement-related health effects in the long term. A period of acute grief that peaks in the 6 months after the death, followed by integrated grief (acceptance and adaption to the loss), is common.[1]
  • Importantly, grief is a normal reaction/process to irrevocable loss, including the death of a loved one.[2]
    • Grief is multidimensional, with physical, behavioral, and meaning/spiritual components, and is characterized by a complex set of cognitive, emotional, and social adjustments that follow the loss.
    • The intensity of grief, its duration, and its expression are often intertwined with cultural and societal norms or expectations. Common elements include distress, anxiety, yearning, sadness, and preoccupation.
• Intense, prolonged grief is a severe threat to the survivor’s ability to function in everyday life and may lead to:
  • Clinically significant distress and impairment in work and social functioning
  • Sleep disturbance
  • Disruption in daily activities
  • Suicidal thinking, and behavior
  • Impairment in relationship functioning
  • Increased use of tobacco, alcohol, or other substances