Prolonged grief is a distinct disorder, researchers say

Writing in PLoS, the online journal of the Public Library of Science, they describe the components of prolonged grief disorder, a consensus they tested by interviewing almost 300 recently widowed Connecticut residents three times over the two years since they had lost their spouses. In previous work, Prigerson found that yearning for a lost loved one was the most powerful emotion bereaved people felt, whether they were experiencing normal grief or its more complicated form.

In the new study, painful yearning was the most common symptom of prolonged grief disorder, experienced by just over two-thirds of the participants. The authors identified nine other symptoms that were felt daily and so deeply that they were disabling more than six months after their loss:

- feeling emotionally numb
- feeling stunned
- feeling that life is meaningless
- experiencing mistrust
- bitterness over the loss
- difficulty accepting the loss
- identity confusion
- avoidance of the reality of the loss
- difficulty moving on with life

People who felt yearning and met at least five of the other criteria were more likely to have thoughts of suicide, be unable to carry out normal functions of life, and to feel their quality of life was poor, the authors found.

"Although most bereaved individuals will eventually adapt to the loss of a significant other more or less successfully, a significant, identifiable minority will experience chronic and disabling grief," they write. "A [prolonged grief disorder] diagnosis has the potential to enhance the detection and effective treatment of a substantial cause of morbidity among persons who have experienced the loss of a significant other."

The diagnostic manual being updated now has generated controversy over potential conflicts of interest involving its authors. Prigerson and her colleague address this at the end of their paper:

"In light of the recent concerns about financial conflicts of interest in psychiatric research, especially that which involves pharmaceutical manufacturers, it is noteworthy that this study was federally funded by the US [National Institutes of Mental Health], and no part of this research was sponsored by producers of a potential therapeutic remedy for prolonged grief disorder."