Examination of the New ICD-11 Prolonged Grief Disorder Guidelines Across Five International Samples


  • Clare Killikelly Orcid
  • Mariia Merzhvynska Orcid
  • Ningning Zhou Orcid
  • Eva-Maria Stelzer Orcid
  • Philip Hyland Orcid
  • Jose Rocha Orcid
  • Menachem Ben-Ezra Orcid
  • Andreas Maercker Orcid


Background: Prolonged grief disorder (PGD) is a new disorder included in the 11th edition of the International classification of diseases (ICD-11). An important remit of the new ICD-11 is the global applicability of the mental health disorder guidelines or definitions. Although previous definitions and descriptions of disordered grief have been assessed worldwide, this new definition has not yet been systematically validated. Method: Here we assess the validity and applicability of core items of the ICD-11 PGD across five international samples of bereaved persons from Switzerland (N = 214), China (N = 325); Israel (N = 544), Portugal (N = 218) and Ireland (N = 830). Results: The results confirm that variation in the diagnostic algorithm for PGD can greatly impact the rates of disorder within and between international samples. Different predictors of PGD severity may be related to sample differences. Finally, a threshold for diagnosis of clinically relevant PGD symptoms using a new scale, the International Prolonged Grief Disorder Scale (IPGDS), in three samples was confirmed. Conclusions: Although this study was limited by lack of questionnaire data points across all five samples, the findings for the diagnostic threshold and algorithm iterations have implications for clinical use of the new ICD-11 PGD criteria worldwide.