Unit for Bereavement Research, Dept. of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
Unit for Psycho-Oncology and Health Psychology, Dept. of Oncology, Aarhus University Hospital and Dept. of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
Clin Psychol Rev. 2024 Feb;107:102375. doi: 10.1016/j.cpr.2023.102375. Epub 2023 Dec 29.
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).
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.
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.
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.
延长哀伤障碍（PGD）的诊断最近已被纳入 ICD-11 和 DSM-5-TR。为了确定需要帮助应对哀伤的个体，需要了解哪些人有发展 PGD 的风险。因此，我们对延长哀伤症状（PGS）的风险因素进行了全面的系统回顾和荟萃分析。
基于对 PsycInfo、PubMed、Web of Science 和 CINAHL 的文献搜索，我们将最常研究的风险因素纳入荟萃分析。使用效应大小相关性作为风险因素与 PGS 之间关联强度的标准化衡量标准。
基于 1989 年至 2023 年间发表的 120 项研究、涉及 61580 名参与者的研究，有 19 个风险因素纳入荟萃分析。对于调整后的关联，与 PGS 最强的关联是失前悲伤症状（ESr=0.39，95%CI[0.24-0.53]）和抑郁（ESr=0.30，95%CI[0.13-0.44]）。观察到一些较小但具有统计学意义的关联，包括意外死亡、暴力/非自然死亡、低教育水平、低收入、女性性别、焦虑依恋风格以及子女或伴侣死亡。
提出了 PGS 风险因素的最新概述，包括其预测强度。这些结果提供了可以帮助预防和早期识别有发展 PGD 风险的人的知识。
