Table 1.

Comparison of diagnostic criteria for prolonged grief disorder (PGD).

ICD-11 PGD criteria		PGD-2009 criteria
A. At least one of the following	1. Persistent and pervasive longing for the deceased or 2. A persistent and pervasive preoccupation with the deceased	A. Event	Bereavement (loss of a significant other)
B. Examples of intense emotional pain	Accompanied by intense emotional pain e.g. sadness, guilt, anger, denial, blame Difficulty accepting the death Feeling one has lost a part of one’s self An inability to experience positive mood Emotional numbness Difficulty in engaging with social or other activities	B. Separation distress	The bereaved person experiences yearning (e.g. craving, pining or longing for the deceased; physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased) daily or to a disabling degree
C. Time and impairment criterion	Persisted for an abnormally long period of time (more than 6 months at a minimum): following the loss, clearly exceeding expected social, cultural or religious norms for the individual’s culture and context. Grief reactions that have persisted for longer periods that are within a normative period of grieving given the person’s cultural and religious context are viewed as normal bereavement responses and are not assigned a diagnosis.  The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning.	C. Cognitive, emotional and behavioural symptoms	The bereaved person must have five (or more) of the following symptoms experienced daily or to a disabling degree: 1. Confusion about one’s role in life or diminished sense of self (i.e. feeling that a part of oneself has died) 2. Difficulty accepting the loss 3. Avoidance of reminders of the reality of the loss 4. Inability to trust others since the loss 5. Bitterness or anger related to the loss 6. Difficulty moving on with life (e.g. making new friends, pursuing interests) 7. Numbness (absence of emotion) since the loss 8. Feeling that life is unfulfilling, empty or meaningless since the loss 9. Feeling stunned, dazed or shocked by the loss
		D. Timing	Diagnosis should not be made until at least 6 months have elapsed since the death
		E. Impairment	The disturbance causes clinically significant impairment in social, occupational or other important areas of functioning (e.g. domestic responsibilities)
		F. Relation to other mental disorders	The disturbance is not better accounted for by major depressive disorder, generalized anxiety disorder or post-traumatic stress disorder

ICD-11, 11th edition of the International Classification of Diseases.