Brief report Prevalence and determinants of complicated grief in general population Daisuke Fujisawa a,b,c, ⁎, Mitsunori Miyashita d , Satomi Nakajima e , Masaya Ito e,f , Motoichiro Kato b , Yoshiharu Kim e a Psycho-oncology Division, National Cancer Center East, Japan b Department of Neuropsychiatry, Keio University School of Medicine, Japan c Division of Palliative Care, Keio University Hospital, Japan d Department of Palliative Nursing, Health Science, Tohoku University Graduate School of Medicine, Japan e National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan f Research Fellow of the Japan Society for the Promotion of Science, Japan article info abstract Article history: Received 27 December 2009 Accepted 3 June 2010 Available online 1 July 2010 Background: Few epidemiological studies have examined complicated grief in the general population, especially in Asian countries. Therefore, this study aimed to explore the prevalence and predictors of complicated grief among community dwelling individuals in Japan. Methods: A questionnaire survey regarding grief and related issues was conducted on community dwelling individuals aged 40–79 who were randomly sampled from census tracts. Complicated grief was assessed using the Brief Grief Questionnaire. Stepwise logistic regression analysis was conducted in order to identify predictors of complicated grief. Results: Data from 969 responses (response rate, 39.9%) were subjected to analysis. The analysis revealed 22 (2.4%) respondents with complicated grief and 272 (22.7%) with subthreshold complicated grief. Respondents who were found to be at a higher risk for developing complicated grief had lost their spouse, lost a loved one unexpectedly, lost a loved one due to stroke or cardiac disease, lost a loved one at a hospice, care facility or at home, or spent time with the deceased everyday in the last week of life. Limitations: Limitations of this study include the small sample size, the use of self-administered questionnaire, and the fact that the diagnoses of complicated grief were not based on robust diagnostic criteria. Conclusions: The point prevalence of complicated grief within 10 years of bereavement was 2.4%. Complicated grief was maintained without significant decrease up to 10 years after bereavement. When subthreshold complicated grief is included, the prevalence of complicated grief boosts up to a quarter of the sample, therefore, routine screening for complicated grief among the bereaved is desired. Clinicians should pay particular attention to the bereaved families with abovementioned risk factors in order to identify people at risk for future development of complicated grief. © 2010 Elsevier B.V. All rights reserved. Keywords: Prevalence Determinant Complicated grief General population Epidemiology Cancer 1. Background Grief, or the emotional reaction to bereavement, is a normal, natural human experience. Most people manage to come terms with grief over time. Nevertheless, it is associated with a period of intense suffering, and for some individuals, the grieving process is disturbed and/or prolonged, which leads to a state of complicated grief. Complicated grief has been defined as a deviation from the normal grief experience in terms of either the time course, intensity, or both. It is associated with increased risk of negative health consequences, including various physical symptoms, depression, higher alcohol consumption, greater use of medical services, higher functional impairment, decreased social par- ticipation, and higher mortality due to suicide and other Journal of Affective Disorders 127 (2010) 352–358 ⁎ Corresponding author. Psycho-oncology Division, National Cancer Center East, Japan. 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, Japan. Tel.: +81 4 7134 7013; fax: +81 4 7134 7026. E-mail address: dai_fujisawa@yahoo.co.jp (D. Fujisawa). 0165-0327/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2010.06.008 Contents lists available at ScienceDirect Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad