What Exactly Is “Complicated” Grief? A Scoping Research Literature Review to Understand Its Risk Factors and Prevalence

Abstract

Most people will experience bereavement grief, but some suffer from persistent or prolonged (PoP) grief, grief that used to be identified as “complicated” before recent DSM-5 and ICD-11 definitional developments. In 2020, a scoping literature review was undertaken to identify and consolidate contemporary evidence from research articles published in 2018 or 2019 in paper-based and open access peer-review journals on: (a) the incidence or prevalence of PoP grief, and (b) who develops it or is diagnosed as suffering from it, and correspondingly what causative factors or predictors are associated with PoP grief. All of the 11 identified research articles reported an incidence or prevalence rate, with these varying greatly, but with a much higher rate now that a 6-month post-death measurement timeframe is used. The predictors or factors among people who were identified as having PoP grief also varied considerably, although sudden and unexpected deaths were often implicated.

On the Classification and Reporting of Prolonged Grief: Assessment and Research Guidelines

“…Of those articles, 8 were excluded because they were not focused specifically on prevalence of grief disorders, 1 was excluded because it was a letter to the editor, and 1 because the article could not be retrieved, leaving 22 articles for data extraction. See Table 1 21–42 …”

Evaluation of Bereavement Assessment Within Inpatient Palliative Care Consultation

“…Complicated grief risk factors were also noted, including whether the patient had a familial primary caregiver, whether the patient had young children (under 25), whether mental health diagnoses existed either in the patient or family, whether there was a history of substance abuse issues in the patient or family, if there was a history of multiple losses in the family, and whether traumatic or sudden death of the patient had occurred, knowing that these factors can put individuals at risk for developing complicated grief. [20][21][22] An "other" category was included to reflect identifiable risks during review such as difficulty coping, family dynamics, and complex medical decision making.…”

Consulting the Oracle: A Delphi study for determining parameters for a mental health user profile and personalization strategy for an online service to aid grieving older adults

“…The loss of a spouse is a frequent occurrence in later life. While most bereaved adults successfully process the loss and continue to lead a normal life, some (about 9% of the bereaved population according to a recent prevalence study ( Wilson et al, 2020 )) have difficulties overcoming bereavement and develop complicated grief. Complicated grief in adults is a condition where severe grief symptoms occur longer than six months after bereavement and frequently results in a multitude of mental and physical problems, such as depression, loneliness, cardiovascular problems and, in extreme cases, suicidal tendencies ( Molina et al, 2019 ).…”