Associated Comorbidities and Clinical Features of Prolonged Grief Disorder Diagnosis Among Bereaved Individuals: A Retrospective Electronic Health Record (EHR)-Based Cohort Study Using TriNetX

Background Prolonged Grief Disorder (PGD) is a recently recognized psychiatric condition characterized by persistent and debilitating grief following the loss of a loved one. While its clinical relevance is increasingly acknowledged, there is a limited understanding of its epidemiological profile and associated healthcare utilization patterns. This study aimed to characterize the demographic, clinical, and healthcare features of individuals diagnosed with PGD using a large multicenter electronic health record dataset. Methods We performed a retrospective cohort analysis using the TriNetX research network (TriNetX, LLC, Cambridge, MA) to identify individuals diagnosed with PGD using the ICD-10 code F43.81. A control cohort was constructed from bereaved individuals without a diagnosis of Prolonged Grief Disorder (PGD) and matched to the PGD cohort on age. Baseline demographic variables (age, sex, race, ethnicity), psychiatric diagnoses, substance use disorders, and emergency department (ED) utilization were extracted and compared between cohorts. Statistical comparisons between cohorts were conducted using chi-squared tests for categorical variables and independent samples t-tests for continuous variables. Results The PGD cohort included 2,464 participants, of whom 1,836 (74.5%) were female and 1,755 (71.2%) were White, with a mean age of 59.2 years. The control cohort comprised 91,868 participants. Depressive episodes were present in 1,995 (81.0%) PGD individuals and 49,835 (54.3%) controls. Recurrent major depressive disorder was identified in 1,370 (55.6%) PGD individuals and 24,795 (27.0%) controls. Other anxiety disorders were observed in 1,988 (80.7%) PGD individuals and 55,802 (60.8%) controls. Alcohol-related disorders were documented in 598 (24.3%) PGD individuals and 16,906 (18.4%) controls, while nicotine dependence occurred in 964 (39.1%) PGD individuals and 29,636 (32.3%) controls. Emergency department utilization was higher among PGD individuals, occurring in 1,940 (78.7%) individuals and 65,385 (71.2%) controls. Differences across nearly all diagnostic categories were statistically significant. Conclusions Individuals with Prolonged Grief Disorder demonstrate a substantially elevated burden of psychiatric comorbidities and increased healthcare utilization. These findings reinforce the importance of recognizing PGD as a clinically meaningful diagnosis with significant implications for mental health services. Future research is needed to evaluate treatment strategies and long-term outcomes for this population.