Grief and bereavement are normal responses to death with gradual recovery expected. Unfortunately, 10% to 15% of bereaved individuals do not adapt to their loss but instead experience acute grief symptoms well beyond the usual 6 to 12 months’ recovery period. This prolonged grieving period with absent adaptation is referred to as complicated grief (CG). Complicating CG diagnosis and treatment is a lack of consensus on terminology and key symptoms by individual researchers/clinicians and the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases 11th Revision.
Complicated grief disproportionately affects older adults with more than 25% of bereaved older adults experiencing CG. Compounded losses of multiple family members/ friends, increased likelihood the deceased is a spouse or partner, and loss related financial burden are factors in this higher incidence. Complicated grief is associated with numerous negative psychological effects including loneliness, social isolation, anxiety, clinical depression, and cognitive impairment. Individuals presenting with a primary diagnosis of CG exhibit elevated rates of comorbid post-traumatic stress disorder (PTSD) 48% current, 52% lifetime. High rates of CG have also been documented in individuals with a primary diagnosis of major depressive disorder.
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