Disturbed Grief in DSM-5 and ICD-11: Overlapping or Different Syndromes?

Abstract

Background: Three decades of research on disturbed grief has led to the inclusion of persistent complex bereavement disorder (PCBD) in DSM-5 and prolonged grief disorder in ICD-11. For clinical practice and research, it is important that PCBD and PGD represent the same construct. Objective: We conducted three studies, the goal of which was to evaluate differences and overlap between criteria for PCRS and PGD. Method: The first was a cross-sectional study with over 400 bereaved people. The second was a longitudinal study including 500 individuals. The third evaluated PCBD and PGD among 8–18-year-olds. Results: Outcomes of the studies indicated that (i) PCBD encompasses three distinguishable symptom-clusters and PGD one cluster, (ii) both syndromes are strongly associated with concurrent posttraumatic stress and depression, (iii) PCBD is considerably less prevalent than is PGD and (iv) PCBD has better predictive validity. Conclusions: PCRS and PGD are not completely overlapping syndromes. Implications of this outcome are discussed with a specific focus on what can be done to harmonize the two criteria-sets, in order to foster research and care focused on helping the bereaved.