The following is a summary of “Comorbid Prolonged Grief, PTSD, and Depression Trajectories for Bereaved Family Surrogates,” published in the November 2023 issue of Critical Care Medicine by Wen et al.
For a study spanning January 2018 to March 2020, investigators investigated co-occurring trajectories of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depressive symptoms among decision-making surrogates post-death. Data analysis occurred between August and December 2022.
The study involved 303 participants. Researchers found that most were under 56 years old (68.3%), female (58.4%), and married (75.2%). Their relationships with the patients were primarily spouses (29.0%) or adult children (54.8%). They identified three distinct trajectories for prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), and depressive symptoms. The prevalent trajectory observed for PGD (83.5%), PTSD (82.5%), and depressive symptoms (66.0%) was resilience. The second most common trajectory for PGD (11.9%) and PTSD (13.5%) was recovery, while for depressive symptoms, a moderate trajectory (23.8%) represented persistent moderate distress.
A chronic trajectory, marked by sustained high distress, was noticed for PGD (4.6%) and depressive symptoms (10.2%). However, a unique delayed-onset trajectory was identified for PTSD symptoms (4.0%). Most family surrogates (75.2%) encountered coexisting trajectories of PGD, PTSD, and depressive symptoms, although multiple patterns showed inconsistency. The concurrent patterns included resilient (81.5%), recovered (14.1%), and distressed (4.5%) trajectories, characterized by distinct conditional probabilities for each symptom trajectory: resilience (PGD, 0.999; PTSD, 0.999; depressive, 0.804), recovery (PGD, 0.854; PTSD, 0.890; depressive, 0.588), and chronicity (PGD, 0.921; PTSD, 0.789; depressive, 0.980).
The findings revealed intricate changes in grief-related psychological symptoms among ICU-bereaved individuals, showcasing diverse trajectories. Certain surrogates faced continuous heightened symptoms of PGD, PTSD, and depression, emphasizing the need for early identification and screening of this group prone to combined psychological distress.
Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2811643