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. 2013 Dec;30(12):1211-6.
doi: 10.1002/da.22093. Epub 2013 Mar 11.

Complicated grief symptoms in anxiety disorders: prevalence and associated impairment

Luana Marques  1 , Eric Bui, Nicole LeBlanc, Eliora Porter, Donald Robinaugh, M Taylor Dryman, Mireya Nadal-Vicens, John Worthington, Naomi Simon
Affiliations

Complicated grief symptoms in anxiety disorders: prevalence and associated impairment

Luana Marques et al. Depress Anxiety. 2013 Dec.

Abstract

Background: Previous research has identified high rates of comorbid anxiety disorders among individuals presenting with primary CG. In the present study, we examined the prevalence of comorbid CG in bereaved primary anxiety disorder (AD) patients compared to bereaved healthy controls. We also examined the impairment associated with comorbid CG in AD.

Methods: Participants were 242 bereaved adults (mean (SD) age = 41.5 (13.1), 44.2% women) with a primary AD diagnosis, including generalized anxiety disorder (GAD; n = 57), panic disorder (PD; n = 49), posttraumatic stress disorder (PTSD; n = 29), and generalized social anxiety disorder (GSAD; n = 107), as well as 155 bereaved healthy controls with no current DSM-IV Axis I diagnosis (mean (SD) age = 43.0 (13.6), 51.0% women). CG symptoms were measured using the 19-item inventory of complicated grief (ICG), with threshold CG defined as an ICG score of ≥30. Quality of life and functional impairment were assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Range of Impaired Functioning Tool (LIFE-RIFT), respectively.

Results: Participants with primary ADs had significantly higher rates of threshold CG symptoms than bereaved controls (12.0% vs. 0.65%; Fisher's Exact P < 0.001). Rates of threshold CG were significantly elevated for each AD when compared to bereaved controls. After adjustment for age, sex, education, and comorbid major depressive disorder, threshold CG was associated with lower quality of life (β = -0.140, P = 0.023) and greater impairment (β = 0.141, P = 0.035) among individuals with AD.

Conclusions: Our findings suggest that threshold CG is of clinical relevance in bereaved individuals with a primary anxiety disorder. Screening for CG in patients with ADs may be warranted.

Keywords: Complicated grief; anxiety; bereavement; comorbidity; grief; quality of life.

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Conflict of interest statement

Conflict of interest disclosures: The present study was supported by funding from the Highland Street Foundation, including grant sponsorship and support for travel to meetings. In addition, the authors disclose the following financial activities. LM: Grants (National Institute of Mental Health, Department of Defense, Massachusetts General Hospital/Partners internal grant) and payment for lectures (Massachusetts General Hospital Psychiatry Academy), EB: Payment for manuscript preparation (Laboratoires Servier), NL: None, EP: None, DR: Payment for manuscript preparation (Current Psychiatry), MTD: None, MNV: Grants (National Institute of Mental Health), payment for manuscript preparation (Dialogues in Clinical Neuroscience), payment for the development of educational presentations (Falcon Reviews), other: clinical investigator training program at Harvard Medical School, which is partially funded by Merck and Pfizer, JW: None, NS: Grants (American Foundation for Suicide Prevention, Department of Defense, National Institute of Mental Health, Forest Laboratories, American Cancer Society, NARSAD, Glaxo SmithKline, Lilly, Sepracor, and Pfizer) and payment for lectures (MGH Psychiatry Academy).

References

    1. Prigerson HG, Horowitz MJ, Jacobs SC, et al. Prolonged grief disorder: psychometric validation of criteria proposed for DSMV and ICD-11. PLoS Med. 2009;6(8):e1000121. - PMC - PubMed
    1. Kersting A, Brahler E, Glaesmer H, Wagner B. Prevalence of complicated grief in a representative population-based sample. J Affect Disord. 2011;131(1–3):339–343. - PubMed
    1. Silverman GK, Johnson JG, Prigerson HG. Preliminary explorations of the effects of prior trauma and loss on risk for psychiatric disorders in recently widowed people. Isr J Psychiatry Relat Sci. 2001;38(3–4):202–215. - PubMed
    1. Bonanno GA, Kaltman S. The varieties of grief experience. Clin Psychol Rev. 2001;21(5):705–734. - PubMed
    1. Shear MK, Simon N, Wall M, et al. Complicated grief and related bereavement issues forDSM-5. Depress Anxiety. 2011;28(2):103–117. - PMC - PubMed

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