The prevalence of prolonged grief disorder in patients with common mental disorders: a comparative study between patients with and without a refugee background in the Netherlands.

BACKGROUND: The recent inclusion of prolonged grief disorder (PGD) in international classification systems marks worldwide recognition of the potential impact of bereavement on mental health. PGD is often overlooked in psychiatric care, and little is known about the prevalence of PGD among individuals referred to secondary mental health care for treatment of common mental disorders including anxiety disorders, posttraumatic stress disorder (PTSD), and depression. Symptoms of these common mental disorders may overlap with PGD symptoms. OBJECTIVE: In the current pilot study, we investigated the prevalence of PGD in N = 45 patients with common mental disorders referred to outpatient clinics of a secondary mental health care center who reported having lost a loved one due to death. METHODS: We included patients with (n=19) and without (n=26) a refugee background, to compare individuals who lost a loved one in different contexts. The Traumatic Grief Inventory-Clinician Administered (TGI-CA) was used to assess the prevalence of PGD and PGD symptom severity and the Mini-SCAN to diagnose common mental disorders. RESULTS: Up to 34% of the sample had a PGD according to both DSM-5-TR and ICD-11 criteria, against 9,8% in general populations. The TGI-CA scoring methods showed perfect agreement between ICD-11 and DSM-5-TR criteria. In univariate analyses, refugees had a two to three times higher risk of PGD compared to non-refugees, and higher PGD symptom severity was associated with being female, refugee, and having an anxiety disorder or PTSD. In multivariate analysis, the influence of refugee status on PGD symptom severity proved to be most prominent for younger patients. CONCLUSIONS: These pilot study results suggest that it is recommendable to investigate PGD in larger samples and to assess the TGI-CA among patients with common mental disorders, particularly in refugee patients.