The Smoldering Pandemic: Self-Reported Prevalence Assessment of Prolonged Grief Disorder. A cross sectional study of bereaving adults during the Covid Pandemic in Pakistan. (preprint)

ABSTRACT

Introduction: The Covid-19 pandemic brought forward unprecedented psycho-social challenges for the world. The devastating loss of human lives created a burden of grief throughout the world. The bereaved were put at a greater risk of grief complications with high death tolls, strict social isolation guidelines and a halt to communal funeral practices. Prolonged Grief Disorder is a young psychiatric condition which refers to an abnormal grief reaction that exceeds the normal cultural, social and religious norms. In this study, we assessed the prevalence of Prolonged Grief Disorder (PGD), as mentioned in ICD-11 in Pakistan, along with its correlation to anxiety, depression and psychological distress. Severity of grief reactions were compared with the place of death and relationship with the deceased. Methods: A cross sectional online survey was conducted during the month of October 2021. Sample size was calculated using OpenEpi and data was collected through non probability sampling. The questionnaire was validated and shared through multiple social forums. A total of 737 participants residing in Lahore Pakistan, who had lost a close one due to Covid-19 participated in the study. Demographics, loss related information, and self-reported symptoms measured by 13-item Prolonged Grief Disorder Scale, Patient Health Questionnaire-4 and Kessler-6 scales were obtained. Results:The prevalence of Prolonged Grief Disorder was found to be 15.4%. There was a significant correlation of grief intensity with depression and anxiety.Prolonged Grief Disorder puts individuals at greater risk of suffering from serious mental illnesses. People who were closely related to the deceased were more likely to experience severe Prolonged Grief Disorder symptoms. Conclusion: Early detection and treatment of high risk individuals is necessary to mitigate the burden of grief and associated risk of anxiety and depression. Overall we conclude that discussions pertaining to grief and measures to curb the psychological effects are crucial in the post-pandemic world.