Official Diagnostic Criteria

The most recent versions of standard official diagnostic guidelines include a diagnosis of “Prolonged Grief Disorder" in DSM 5 and ICD11. This is the condition we have been calling complicated grief.

ICD11: In 2018 the World Health Organization approved a new diagnosis of Prolonged Grief Disorder. Guidelines for this diagnosis include the occurrence of a “persistent and pervasive grief response characterized by longing for the deceased or persistent preoccupation with the deceased accompanied by intense emotional pain (e.g. sadness, guilt, anger, denial, blame, difficulty accepting the death, feeling one has lost a part of one’s self, an inability to experience positive mood, emotional numbness, difficulty in engaging with social or other activities)”. You can find the full guideline here.

DSM 5: In 2020 the American Psychiatric Association approved a new diagnosis of Prolonged Grief Disorder. The official announcement is pending. The criteria for this disorder are more specific; however our data and that of others confirm that they harmonize well. DSM V PGD requires the occurrence of a persistent and pervasive grief response characterized by persistent longing or yearning and/or preoccupation with the deceased accompanied by at least 3 of 8 additional symptoms that include disbelief, intense emotional pain, feeling of identity confusion, avoidance of reminders of the loss, feelings of numbness, intense loneliness, meaninglessness or difficulty engaging in ongoing life.

Differential diagnosis: PGD is most often confused with depression. There is solid evidence that treatment for depression is far less helpful than targeted grief treatment so this difference is important. Core symptoms of PGD are persistent yearning and preoccupation with the deceased whereas core symptoms of depression are pervasive “free-floating” sadness and loss of interest and pleasure. These differences can help you distinguish grief from depression.

Tens of millions of people worldwide are struggling with PGD

Intense grief is typical after we lose someone close. Grief remains intense until we adapt to the loss. For an estimated 10-15% of bereaved people in the general population, adapting is problematic. Rates are higher when the death is sudden, unexpected or violent and when a young person dies. Risk factors for PGD include a prior history of mood or anxiety disorders. Women are at higher risk than men. An estimated 20% of people receiving mental health treatment have unrecognized PGD.