DSM-5-TR prolonged grief disorder levels after natural, COVID-19, and unnatural loss during the COVID-19 pandemic

Background and objectives: A rise in prolonged grief disorder (PGD) levels was expected due to COVID-19 deaths. We tested this assumption, by comparing PGD-severity among people who experienced a death of a loved one during the pandemic caused by a natural (e.g., illness), COVID-19, or unnatural (e.g., accidents, suicides, homicides) loss on average 8 months earlier and in a subgroup of people bereaved ≥12 months earlier. Design and methods: Self-rated DSM-5-TR (acute) PGD levels (using the Traumatic Grief Inventory-Self Report plus) were compared among Dutch adults who experienced a natural (N = 1036), COVID-19 (N = 76), or unnatural loss (N = 271) during the pandemic. Analyses of covariance were used. Results: About two-thirds of the participants scored above the cut-off for (acute) probable PGD. Significantly higher acute PGD-severity was found in people after unnatural loss compared with COVID-19 (B = -2.44 (SE=0.87), p = .005) or natural loss (B = -1.78 (SE=0.45), p<.001). No significant differences in acute PGD-severity was found between people who experienced a natural or COVID-19 loss (B = 0.66 (SE=0.80), p = .413). PGD levels did not differ between the three groups for people who lost their loved one ≥12 months earlier (N = 380). Conclusions: We found that acute PGD-severity was significantly higher following unnatural deaths than after COVID-19 deaths or natural causes, but no differences were found for people who experienced a loss ≥12 months earlier.