Lundorff Marie, Holmgren Helle, Zachariae Robert, Farver-Vestergaard Ingeborg, O'Connor Maja
Research Unit for Natural and Complicated Grief, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
Research Unit for Natural and Complicated Grief, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
J Affect Disord. 2017 Apr 1;212:138-149. doi: 10.1016/j.jad.2017.01.030. Epub 2017 Jan 23.
Prolonged grief disorder (PGD) is a bereavement-specific syndrome expected to be included in the forthcoming ICD-11. Defining the prevalence of PGD will have important nosological, clinical, and therapeutic implications. The present systematic review and meta-analysis aimed to estimate the prevalence rate of PGD in the adult bereaved population, identify possible moderators, and explore methodological quality of studies in this area.
A systematic literature search was conducted in PubMed, PsycINFO, Embase, Web of Science, and CINAHL. Studies with non-psychiatric, adult populations exposed to non-violent bereavement were included and subjected to meta-analytic evaluation.
Fourteen eligible studies were identified. Meta-analysis revealed a pooled prevalence of PGD of 9.8% (95% CI 6.8-14.0). Moderation analyses showed higher mean age to be associated with higher prevalence of PGD. Study quality was characterized by low risk of internal validity bias but high risk of external validity bias.
The available studies are methodologically heterogeneous. Among the limitations are that only half the studies used registry-based probability sampling methods (50.0%) and few studies analyzed non-responders (14.3%).
This first systematic review and meta-analysis of the prevalence of PGD suggests that one out of ten bereaved adults is at risk for PGD. To allocate economic and professional resources most effectively, this result underscores the importance of identifying and offer treatment to those bereaved individuals in greatest need. Due to heterogeneity and limited representativeness, the findings should be interpreted cautiously and additional high-quality epidemiological research using population-based designs is needed.
持续性悲伤障碍（PGD）是一种特定于丧亲之痛的综合征，预计将纳入即将发布的《国际疾病分类第11版》（ICD - 11）。确定PGD的患病率将具有重要的疾病分类学、临床和治疗意义。本系统评价和荟萃分析旨在估计成年丧亲人群中PGD的患病率，确定可能的调节因素，并探讨该领域研究的方法学质量。
在PubMed、PsycINFO、Embase、Web of Science和CINAHL中进行了系统的文献检索。纳入了非精神科成年人群经历非暴力丧亲事件的研究，并进行荟萃分析评估。
确定了14项符合条件的研究。荟萃分析显示PGD的合并患病率为9.8%（95%置信区间6.8 - 14.0）。调节分析表明，平均年龄越高，PGD的患病率越高。研究质量的特点是内部效度偏差风险低，但外部效度偏差风险高。
现有研究在方法学上存在异质性。局限性包括只有一半的研究使用基于登记处的概率抽样方法（50.0%），很少有研究分析无应答者（14.3%）。
这项关于PGD患病率的首次系统评价和荟萃分析表明，每十名丧亲成年人中就有一人有患PGD的风险。为了最有效地分配经济和专业资源，这一结果强调了识别并为最需要的丧亲个体提供治疗的重要性。由于存在异质性和代表性有限，这些发现应谨慎解释，需要使用基于人群的设计进行更多高质量的流行病学研究。
