[Toward an integrated understanding of traumatic grief - connecting prolonged grief, posttraumatic stress and depression symptoms].

BACKGROUND:Psychological grief symptoms following bereavement have been extensively researched and described, with the distinction, generally speaking, of three sets of disorders: prolonged grief disorder, posttraumatic stress disorder and depression. AIM:To investigate the connection and co-occurrence between the symptoms of these three disorders. METHOD:Conducting and combining studies from a categorical, dimensional, person-centered and network perspective on psychopathology. RESULTS:We found a prevalence of 49% of prolonged grief disorder among traumatically bereaved individuals. Of all bereaved patients referred to a psycho-trauma clinic, 65% experienced prolonged grief symptoms next to posttraumatic stress symptoms. Symptoms related to social isolation and diminished sense of self were identified as bridge symptoms of co-morbidity. Treatment for prolonged grief next to posttraumatic stress symptoms might cause symptom reduction, even in refugees with multiple post-migration stressors. Lastly, we found a surprisingly low prevalence rate among bereaved families following traffic accidents on the Indonesian island of Bali, compared to other countries. This suggests that psychopathology needs to be understood in its cultural context. CONCLUSION:To better understand co-morbidity it may be beneficial to combine different perspectives on psychopathology. Clinicians should be aware of prolonged grief symptoms in order to adequately capture psychopathology among those affected by trauma and loss.