Complicated grief: A descriptive cross-sectional prevalence study from Iran

Introduction: The ability of people to accept grief has a wide range from acceptance of grief to development of serious complications. The prevalence and complications of grief vary due to the differences in social norms and cultural expectations. Objective: We aimed to assess the point prevalence of complicated grief in one of western provinces of Iran. Methods: This study was performed as a cross-sectional survey of 751 subjects who attended an outpatient psychiatry center in Kermanshah from July to December 2012. The main symptoms and signs of complicated grief as well as presence and severity of depression were assessed using especial questionnaires. Results: Among all assessed referees, 63 were diagnosed to have an experience of recent grief (33 men and 30 women) with the overall prevalence of 8.4%. Among those with recent experience of grief, only 28 had complicated grief with the overall prevalence of 3.73% among which, 3.06% had chronic grief and 0.67% suffered from delayed grief. Many cases were wrongly diagnosed to have other psychological disturbances such as depression or anxiety. The final diagnosis of major depressive disorder grief was confirmed only in 33.4% of complicated grief cases based on BDI ΙΙ score and psychiatrist judgment in our assessment. Conclusion: The complicated grief has a comparable prevalence to previous reported figures in western Iran. Conspicuous number of those who were affected by complicated grief was wrongly diagnosed as other psychological conditions such as depression or anxiety in this study. This fact probably indicates necessity of training programs for primary health care service of this region for getting familiar with manifestations of complicated grief and correct diagnosis of this condition.