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. 2022 Jul;31(7):1144-1151.
doi: 10.1002/pon.5902. Epub 2022 Feb 21.

Prolonged grief disorder and depression are distinguishable syndromes: A latent transition analysis for bereaved family caregivers of cancer patients

Fur-Hsing Wen  1 , Holly G Prigerson  2 , Wen-Chi Chou  3   4 , Jen-Shi Chen  3   4 , Wen-Cheng Chang  3   4 , Mei Huang Hsu  5 , Siew Tzuh Tang  3   5   6
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Prolonged grief disorder and depression are distinguishable syndromes: A latent transition analysis for bereaved family caregivers of cancer patients

Fur-Hsing Wen et al. Psychooncology. 2022 Jul.

Abstract

Objective: To determine whether distinctive prolonged-grief-disorder- (PGD) and depressive-symptom states emerge among family caregivers of cancer patients over their first 2 years of bereavement. This may extend cross-sectional evidence that PGD and major depressive disorder (MDD) symptoms can co-occur/occur independently and validate their construct distinctiveness.

Methods: In this secondary-analysis study, PGD symptoms and depressive symptoms were measured over 666 caregivers using 11 grief symptom items of the Prolonged Grief-13 scale and 16 items of the Center for Epidemiologic Studies-Depression scale, respectively. Distinct PGD/depressive-symptom states were identified by latent transition analysis with dichotomous indicators (presence/absence) of PGD or depressive symptoms.

Results: Four distinct PGD/depressive-symptom states emerged. The resilient and subthreshold depression-dominant states showed low and moderate probabilities of the presence of majority of depressive symptoms, respectively, with no PGD symptoms having a greater than moderate probability of presence. The depression-dominant state was marked by a high probability of the presence for 9 of 16 depressive symptoms, with moderate probabilities for almost all PGD symptoms. The PGD-depression comorbid state was characterized by a high probability of presence of all PGD symptoms and depressive symptoms, except for moderate probabilities of presence of two depressive symptoms.

Conclusion: Our longitudinal identification of a predominantly depressive state but absence of a PGD-dominant state provides further evidence that PGD and MDD are related but distinct constructs that can occur independently or concurrently as the PGD-depression comorbid state. When PGD is suspected, bereaved individuals should be assessed for the potential comorbidity of MDD.

Keywords: cancer; construct distinctiveness; depressive symptoms; end-of-life care; latent transition analysis; oncology; prolonged grief disorder; symptom trajectories.

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References

REFERENCES

    1. Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. Lancet. 2007;370(9603):1960-1973.
    1. Shear MK. Complicated grief. N Engl J Med. 2015;372:153-160.
    1. Prigerson HG, Horowitz MJ, Jacobs SC, et al. Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med. 2009;6:e1000121.
    1. Prior A, Fenger-Grøn M, Davydow DS, et al. Bereavement, multimorbidity and mortality: a population-based study using bereavement as an indicator of mental stress. Psychol Med. 2018;48:1437-1443.
    1. Guldin MB, Ina Siegismund Kjaersgaard M, Fenger-Grøn M, et al. Risk of suicide, deliberate self-harm and psychiatric illness after the loss of a close relative: a nationwide cohort study. World Psychiatr. 2017;16:193-199.

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