This article was first published on November 7, 2023. It was last reviewed, updated, or edited on November 7, 2023.
Prolonged grief disorder consists of maladaptive and distressing/ impairing grief that continues long after the death of someone close to the patient.
Prolonged grief disorder in DSM-5-TR® diagnostic criteria
Prolonged grief disorder is a mental disorder that was included in the ICD-11 (2020). In DSM, it was first included in the chapter on “Conditions for Further Study” but later incorporated in 2022 into DSM-5-TR® as an established diagnostic category (F43.81).
Note: In DSM-5-TR®, prolonged grief disorder is not in the chapter on Depressive Disorders; it is in the chapter on Trauma- and Stressor-Related Disorders (American Psychiatric Association, 2022).
Below is my restatement in my own words of some of the main concepts covered by the DSM-5-TR® diagnostic criteria for prolonged grief disorder.
Note: This is not a complete listing of every element of the diagnostic criteria. Also, some of the criteria below are modified for children and adolescents, which we will discuss separately later.
Three key diagnostic criteria
A. Someone close to the patient died. And, it has been at least one year since that death occurred.
B. Since the death, one or both of the following have been present on most days:
- Intense longing for the person who died.
- Preoccupation with thoughts or memories of the person who died.
C. Since the death, at least 3 of 8 symptoms (listed below) have been present on most days.
Three criteria similar to other disorders
The last 3 items in the diagnostic criteria for prolonged grief disorder are similar to those for other diagnoses.
D. Clinically significant distress or impairment
E. Clearly exceeds social/ cultural/ religious norms.
F. Not better explained by another mental disorder and not attributable to the effects of a substance or another medical condition.
Eight listed symptoms
The diagnostic criteria for prolonged grief disorder in DSM-5-TR® include the presence of at least 3 of the following 8 symptoms since and because of the death of a person who was close to the patient.
To help us grasp these 8 symptoms conceptually, I have grouped them into Pain, Avoidance, and Impairment, based on which ones seemed to me to be similar or related.
Pain
Intense emotional pain about the death.
Intense loneliness
Avoidance
Marked sense of disbelief about the death.
Emotional numbness
Avoidance of reminders that the person is dead.
Impairment
Identity disruption; for example, feeling as if a part of oneself has died.
Feeling that life is meaningless
Difficulty with relationships and activities
Related Pages
Grief versus Major Depression
An overview of DSM-5 diagnostic categories
An overview of Trauma- and Stressor-Related Disorders
Main menu: Mental disorders and related conditions
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th ed., text rev (DSM-5-TR).Washington, DC, American Psychiatric Association, 2022.
International Statistical Classification of Diseases and Related Health Problems: Instruction Manual, 11th ed. Geneva, World Health Organization, 2020
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