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Cited by 156Grief, Bereavement, and Mental HealthCOVID-19 and Mental HealthDeath, Funerary Practices, and Mourning

Who suffered most after deaths due to COVID-19? Prevalence and correlates of prolonged grief disorder in COVID-19 related bereaved adults

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Tang, Suqin, Xiang, Zhendong·2021·Globalization and Health
DOI 10.1186/s12992-021-00669-5PMC PMC7877329

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Abstract

Background: Deaths by COVID-19 have left behind nearly 12 million recent bereaved individuals worldwide and researchers have raised concerns that the circumstances of COVID-19 related deaths will lead to a rise prevalence of prolonged grief disorder (PGD) cases. However, to date, no studies have examined the prevalence of PGD among people bereaved due to COVID-19. This study aimed to estimate the prevalence of PGD and investigated demographic and loss-related factors associated with prolonged grief symptoms among Chinese individuals bereaved due to COVID-19. Methods: This was a cross-sectional online survey conducted between September 1 and October 3, 2020. A total of 422 Chinese participants (55.5% males; 32.73 [9.31] years old) who lost a close person due to COVID-19 participated in the study. Demographic and loss-related information was collected, and self-reported prolonged grief symptoms were measured by a 13-item International Prolonged Grief Disorder Scale (IPGDS: 1–65) and a 17-item Traumatic Grief Inventory Self Report (TGI-SR: 1–85). Multiple linear regression analysis was used to determine the associated factors of levels of grief symptoms. Results: Prevalence of PGD was 37.8% screened by IPGDS and 29.3% by TGI-SR. No difference was found in levels of grief symptoms between participants whose close one died more than 6 months ago and those who experienced the loss less than 6 months ago. More severe prolonged grief symptoms assessed by IPGDS was associated with losing a close person by COVID-19 rather than complications (B: 5.35; 95% CI: 0.54–10.05), losing a partner (B: 7.80; 95% CI: 3.24–12.37), child (B: 8.15; 95% CI: 1.03–15.26), and parent (B: 5.49; 95% CI: 1.49–9.48) rather than losing a relative or a person with other relationship, feeling more traumatic about the loss (B: 1.71; 95% CI: 0.52–2.90), being closer with the deceased (B: 1.60; 95% CI: 0.34–2.86). Moreover, Losing a grandparent (B: 6.62; 95% CI: 0.53–12.71) and having more conflicts with the deceased (B: 1.05; 95% CI: − 0.008–2.11) were related to higher levels of grief symptoms assessed by TGI-SR. Conclusions: Echoing researchers’ concerns, the prevalence of PGD is high among people bereaved due to COVID-19. Individuals with a higher risk of developing PGD should be identified and bereavement support should be offered as early as possible.

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  • A study of people who lost a loved one to COVID-19 found a 37.8% prevalence of PGD and a 39.9% prevalence of PCBD.

    “A study undertaken of people who have lost a loved one to COVID-19 found a 37.8% prevalence of prolonged grief disorder (PGD) and a 39.9% prevalence of persistent complex bereavement disorder (PCBD; Tang & Xiang, 2021)”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Tang & Xiang, 2021

    The Results section, under “Prevalence and symptom levels of PGD and PCBD,” reports 37.8% PGD in the subsample bereaved six months earlier, matching the claim. It reports 29.3% PCBD, not 39.9%. (LLM, conf=0.94)

    Experimental — accuracy not yet measured

  • Factors associated with more severe PGD or PCBD symptoms after losing someone close to them to COVID-19 include the absence of traditional funeral rituals, an unexpected or traumatic death, the death of a partner, child, parent or grandparent, or having had a conflict with the deceased.

    “Factors associated with more severe PGD or PCBD symptoms after losing someone close to them to COVID-19 (Tang & Xiang, 2021) have been identified, such as the absence of traditional funeral rituals, when an unexpected or traumatic death occurs, when a partner, child, parent or grandparent dies, or having had a conflict with the deceased.”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Tang & Xiang, 2021

    The Results (Correlates of PGD and PCBD symptoms) associate more severe symptoms with traumatic loss, losing a partner, child or parent, and, for PCBD, losing a grandparent or having conflicts with the deceased. The Background discusses unexpected deaths and the inability to hold traditional funerals, but the paper does not identify the absence of funeral rituals as a separately measured correlate in its study. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The frequency of people with COVID-19-related prolonged grief disorder continues to increase worldwide.

    “This is significant if one considers that the frequency of people with COVID-19-related prolonged grief disorder continues to increase worldwide (Tang & Xiang, 2021).”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Tang & Xiang, 2021

    The Background raises concern about a worldwide rise in prolonged grief disorder after COVID-19 deaths, and the Conclusions report high prevalence among people bereaved due to COVID-19. But the study was a cross-sectional survey of Chinese participants (Abstract, Methods); it does not establish that the number of people with the disorder continues to increase worldwide. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The massive grief following COVID-19 will leave approximately sixteen million people in mourning worldwide.

    “It is estimated that the massive grief following COVID-19 will leave approximately sixteen million people in mourning worldwide.”

    From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Tang & Xiang, 2021

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Research works printed but not linked: 37

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Authors
Tang, S., & Xiang, Z.
Affiliations
Shenzhen University (CN)
Corresponding author
Tang, Suqin
ORCID
Tang, Suqin
Venue
Globalization and Health
Publisher
Springer Science and Business Media LLC
Published
2021-02-11
Volume
17
Issue
1
Pages
19-19
ISSN
1744-8603 (ISSN-L)
DOI
10.1186/s12992-021-00669-5
PMC
PMC7877329
OpenAlex
W3112923053
Cited by
156
References
59
Citations by year
2026: 9 · 2025: 24 · 2024: 30 · 2023: 36 · 2022: 43 · 2021: 14
FWCI
20.97
Type
journal article
Language
en
Open access
Licence
Locations
  • Globalization and Health (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
Funders
  • Guangdong Planning Office of Philosophy and Social Science (GD20YSH06)
  • Shenzhen University (860-000002110172)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
Keywords
prolonged grief disorder, COVID-19 mortality, bereavement, grief symptoms, prevalence, traumatic grief, loss of a partner, loss of a child, parental loss, relationship closeness, Chinese adults, demographic risk factors, bereavement support services, mental health
MeSH terms
COVID-19, Adjustment Disorders, Adult, Bereavement, China, Cross-Sectional Studies, Female, Grief, Humans, Male, Risk Factors, Prevalence

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