Falala Aude, Lannes Alice, Bui Eric, Revet Alexis
Service universitaire de psychiatrie de l'enfant et de l'adolescent, hôpital Purpan, CHU de Toulouse, place du Dr-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
Unité d'hospitalisation pour adolescents, pôle de pédopsychiatrie, hôpitaux de Lannemezan, Lannemezan, France; Inserm, UPS, CERPOP, université de Toulouse, Toulouse, France.
Encephale. 2024 Oct;50(5):557-565. doi: 10.1016/j.encep.2023.11.016. Epub 2024 Feb 26.
Prolonged Grief Disorder (PGD) is a condition recently introduced in international classifications of mental disorders. Although PGD is associated with significant distress and impairment that may have developmental consequences, to date, little is known about its prevalence and associated factors in children and adolescents. The present systematic review registered in PROSPERO (CRD42021236026) aimed to: (i) review existing data on the prevalence of PGD in bereaved children and adolescents; and (ii) identify factors associated with PGD in this population.
Six electronic databases, grey literature and a manually searched journal identified 1,716 articles with no backward limit to September 2021. Epidemiological studies were included if they reported the prevalence of PGD in bereaved children and adolescents. Study characteristics, diagnostic and assessment tools, population, loss-related characteristics and prevalence of PGD were reviewed.
Five studies met our inclusion criteria. The reported prevalences of PGD ranged from 10.4% to 32%. Female gender, cognitive avoidance, chronic stressors such as economic hardship, exposure to trauma or other losses appear to be associated with more severe symptoms or even a higher risk of PGD. Conversely, data suggest social support may be protective.
This first systematic review found a relatively high prevalence of PGD in bereaved children and adolescents. While further large epidemiological studies are needed, this review highlights the importance of evaluating PGD in current clinical practice and suggests that further research into diagnostic and therapeutic approaches targeting this disorder is warranted.
持续性悲伤障碍（PGD）是最近在国际精神障碍分类中引入的一种病症。尽管PGD与可能产生发育后果的显著痛苦和功能损害有关，但迄今为止，对于其在儿童和青少年中的患病率及相关因素知之甚少。在PROSPERO（CRD42021236026）注册的本系统评价旨在：（i）回顾关于丧亲儿童和青少年中PGD患病率的现有数据；以及（ii）确定该人群中与PGD相关的因素。
六个电子数据库、灰色文献以及手动检索的期刊共识别出1716篇截至2021年9月无时间下限的文章。纳入报告了丧亲儿童和青少年中PGD患病率的流行病学研究。对研究特征、诊断和评估工具、人群、与丧失相关的特征以及PGD患病率进行了回顾。
五项研究符合我们的纳入标准。报告的PGD患病率在10.4%至32%之间。女性、认知回避、经济困难等慢性应激源、遭受创伤或其他丧失似乎与更严重的症状甚至更高的PGD风险相关。相反，数据表明社会支持可能具有保护作用。
这首次系统评价发现丧亲儿童和青少年中PGD患病率相对较高。虽然需要进一步开展大型流行病学研究，但本评价强调了在当前临床实践中评估PGD的重要性，并表明有必要对针对该障碍的诊断和治疗方法进行进一步研究。
