title: Complicated grief symptoms in anxiety disorders: prevalence and associated impairment.
abstract: BACKGROUND
  Previous research has identified high rates of comorbid anxiety disorders among individuals presenting with primary CG. In the present study, we examined the prevalence of comorbid CG in bereaved primary anxiety disorder (AD) patients compared to bereaved healthy controls. We also examined the impairment associated with comorbid CG in AD.
  
  
  METHODS
  Participants were 242 bereaved adults (mean (SD) age = 41.5 (13.1), 44.2% women) with a primary AD diagnosis, including generalized anxiety disorder (GAD; n = 57), panic disorder (PD; n = 49), posttraumatic stress disorder (PTSD; n = 29), and generalized social anxiety disorder (GSAD; n = 107), as well as 155 bereaved healthy controls with no current DSM-IV Axis I diagnosis (mean (SD) age = 43.0 (13.6), 51.0% women). CG symptoms were measured using the 19-item inventory of complicated grief (ICG), with threshold CG defined as an ICG score of ≥30. Quality of life and functional impairment were assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Range of Impaired Functioning Tool (LIFE-RIFT), respectively.
  
  
  RESULTS
  Participants with primary ADs had significantly higher rates of threshold CG symptoms than bereaved controls (12.0% vs. 0.65%; Fisher's Exact P < 0.001). Rates of threshold CG were significantly elevated for each AD when compared to bereaved controls. After adjustment for age, sex, education, and comorbid major depressive disorder, threshold CG was associated with lower quality of life (β = -0.140, P = 0.023) and greater impairment (β = 0.141, P = 0.035) among individuals with AD.
  
  
  CONCLUSIONS
  Our findings suggest that threshold CG is of clinical relevance in bereaved individuals with a primary anxiety disorder. Screening for CG in patients with ADs may be warranted.
authors.affiliation: Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Luana
authors.initials: L
authors.lastname: Marques
authors.forename: Eric
authors.initials: E
authors.lastname: Bui
authors.forename: Nicole
authors.initials: N
authors.lastname: LeBlanc
authors.forename: Eliora
authors.initials: E
authors.lastname: Porter
authors.forename: Donald
authors.initials: D
authors.lastname: Robinaugh
authors.forename: M Taylor
authors.initials: MT
authors.lastname: Dryman
authors.forename: Mireya
authors.initials: M
authors.lastname: Nadal-Vicens
authors.forename: John
authors.initials: J
authors.lastname: Worthington
authors.forename: Naomi
authors.initials: N
authors.lastname: Simon
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology*; D001601:Bereavement; D016022:Case-Control Studies; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000523:psychology; D010698:Phobic Disorders / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology
keywords: Complicated grief; anxiety; bereavement; comorbidity; grief; quality of life