Prolonged grief disorder and associated factors among Iranian general population

Background: Prolonged Grief Disorder (PGD) is a recently recognized mental health condition characterized by persistent and intense grief following the loss of a loved one. While global proportion estimates vary, limited data exist regarding PGD within the Iranian general population. This study aimed to determine the proportion of PGD in Iran and examine associated sociodemographic factors. Methods: A cross-sectional survey was conducted among 469 general community dwelling in Shahroud, North east of Iran, using convenience sampling technique. Participants were eligible for inclusion if they were over 18 years old, possessed basic literacy skills, and had experienced the loss of a close loved one (such as a spouse, parent, or child) at least 12 months prior to enrollment. Participants completed online forms of the validated Persian version of the Prolonged Grief Disorder Scale (PG-13-R). Sociodemographic data (age, gender, education, marital, and job status) were collected, and multivariate logistic regression was used to identify factors associated with PGD. Results: The proportion of PGD was 29.6% (95% CI: 28.5–30.5%), with a mean symptom score of 29.54 ± 10.68. A significant difference between PGD-positive and PGD-negative individuals in terms of education (p=0.005) and occupational status (p=0.01). Multivariate analysis indicated that age and education were significant predictors of PGD. Individuals aged 41–60 (OR: 12.7, CI: 1.5 - 107.05, p= 0.019) and over 60 (OR: 14.7, CI: 1.7 - 123.9, p= 0.013) were significantly more likely to meet PGD criteria compared to those under 20. Participants with secondary education were more likely to experience PGD than those with only primary education (OR: 4.1, CI: 2.06 - 8.5, p<0.001). Conclusion: Prolonged grief disorder affects a substantial portion of the Iranian population, particularly among older adults and those with lower educational attainment. These findings highlight the need for targeted mental health interventions and the development of culturally sensitive diagnostic and therapeutic approaches. Future research should explore the moderating roles of religiosity, loneliness, and social support in grief outcomes to inform comprehensive, culturally grounded care strategies.