Background

The diagnosis Prolonged Grief Disorder (PGD) has recently been included in ICD-11 and DSM-5-TR. To identify individuals who need help coping with grief, knowledge is needed about who is at risk of developing PGD. We, therefore, conducted a comprehensive systematic review and meta-analysis of the available literature on risk factors for prolonged grief symptoms (PGS).

Methods

Based on a literature search in PsycInfo, PubMed, Web of Science, and CINAHL, we included the most frequently investigated risk factors in a meta-analysis. The effect size correlation was used as the standardized measure of the strength of the association between the risk factor and PGS.

Results

Based on 120 studies of 61.580 participants published between 1989 and 2023, 19 risk factors were included in the meta-analysis. For the adjusted associations, the strongest associations with PGS were pre-loss grief symptoms (ESr = 0.39, 95%CI[0.24–0.53]) and depression (ESr = 0.30, 95%CI[0.13–0.44]). Small, but statistically significant associations were observed for unexpected death, violent/unnatural death, low educational level, low income, female gender, anxious attachment style, and death of a child or partner.

Conclusions

An updated overview of risk factors for PGS is presented, including their predictive strength. The results offer knowledge that can aid prevention and early identification of people at risk of PGD.

中文翻译：

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长期悲伤症状的危险因素：系统回顾和荟萃分析

背景

长期悲伤障碍 (PGD) 诊断最近已纳入 ICD-11 和 DSM-5-TR。为了识别需要帮助应对悲伤的人，需要了解谁有进行胚胎植入前诊断的风险。因此，我们对有关长期悲伤症状（PGS）危险因素的现有文献进行了全面的系统回顾和荟萃分析。

方法

基于 PsycInfo、PubMed、Web of Science 和 CINAHL 中的文献检索，我们在荟萃分析中纳入了最常研究的风险因素。效应大小相关性被用作危险因素与 PGS 之间关联强度的标准化衡量标准。

结果

基于 1989 年至 2023 年间发表的 120 项研究，涉及 61,580 名参与者，荟萃分析中纳入了 19 个风险因素。对于调整后的关联，与 PGS 最强的关联是失去亲人前的悲伤症状（ESr = 0.39，95%CI[0.24–0.53]）和抑郁症（ESr = 0.30，95%CI[0.13–0.44]）。意外死亡、暴力/非自然死亡、低教育水平、低收入、女性、焦虑依恋风格以及儿童或伴侣死亡之间观察到微小但具有统计学意义的关联。

结论

提供了 PGS 风险因素的最新概述，包括其预测强度。结果提供了有助于预防和早期识别有 PGD 风险的人的知识。