With the introduction of the prolonged grief disorder (PGD) in the ICD-11 and most likely in the future DSM-5-TR, there is clinical need to examine cultural variations in grief phenomenon. We tested whether grief symptoms differ cross-culturally by examining the prevalence rates and predictors of PGD among French and Togolese bereaved individuals.
The sample comprised 235 widowed persons (73 French and 162 Togolese participants). They all completed the Prolonged Grief Scale–11 items. There were no statistically significant differences between both groups in terms of sociodemographic information (except for education). However, they differed on loss-related characteristics. We used two different symptom-diagnostic tests to estimate the prevalence rates.
We found that French and Togolese bereavers reported almost similar PGD prevalence rates (21.9% [95% CI 0.13, 0.36] and 15.4% [95% CI 0.10, 0.23], respectively for the first test, 26% [95% CI 0.16, 0.41] and 17.3% [95% CI 0.12, 0.25], respectively for the second test). Through regression analyses, PGD severity was predicted by low education, being unemployed, long duration of a marital relationship, and traumatic death in the French sample, whereas it was predicted by being male and highly educated in the Togolese sample. Both groups only shared a recent bereavement period as a common risk factor.
Even though French and Togolese widowed persons reported almost similar prevalence rates of PGD, etiology, risk, and protective factors are culturally distinctive. It is critical to consider cultural and individual differences when conducting research on diagnosis and intervention in cases of prolonged grief.
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Prolonged grief disorder, alternatively called “persistent complex bereavement disorder”, has been annexed to the Appendix of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for in-depth investigation to introduce it in the DSM-5-TR (text revision).
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The authors are very grateful to all the participants from France and Togo who gave their time and energy to participate in the survey which made this study possible.
Conflict of interest
The authors declare that they have no conflicts of interest.
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Kokou-Kpolou, C.K., Cénat, J.M., Noorishad, P. et al. A comparison of prevalence and risk factor profiles of prolonged grief disorder among French and Togolese bereaved adults. Soc Psychiatry Psychiatr Epidemiol (2020). https://doi.org/10.1007/s00127-020-01840-w
- Prolonged grief disorder
- Risk and protective factors
- Cross-cultural research