Depression, Complicated Grief, and Suicide Ideation Following Bereavement During the COVID-19 Pandemic

Impact of the contextual factors regarding the COVID-19 pandemic on bereavement: an integrative review of the literature from a bioethical perspective

The advent of the COVID-19 pandemic has profoundly transformed grief around the world. What are the impacts of context factors regarding the COVID-19 pandemic on dysfunctional symptoms of grief? This is a study with a qualitative approach, integrative review, whose article data collection was carried out in the following databases: Biblioteca Virtual de Saúde (BVS), Portal Brasileiro de Publicações e Dados Científicos em Acesso Aberto (Oasisbr), United States National Library of Medicine (PubMed), Scientific Electronic Library (SciELO) and Web of Science. Thirty-three articles were selected for the analysis. The studies showed different results when the risk factors were detailed individually. However, the pandemic context proved to be a complex element that created vulnerability associated with grieving. Bioethics presents itself as a locus of interdisciplinary discussion for a more profound understanding of the complex specificities and, based on the social and political responsibility of Protection Bioethics to protect vulnerable populations, it is recommended to mental health professionals who intentionally explore the impacts of the pandemic on the grieving process. The suffering of people bereaved during the pandemic must be publicly recognized, offering safe spaces for reception and sharing.

Psychometric Evaluation of the Traumatic Grief Inventory-Self Report Plus (TGI-SR+) in Chinese Bereaved People

OBJECTIVE

The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) measures the most recent prolonged grief disorder (PGD) symptom sets defined in the 11th edition of the International Statistical of Diseases and Related Health Problems (ICD-11) and the text revision of the fifth edition of the Diagnostical and Statistical Manual of Mental Disorders (DSM-5-TR). However, the TGI-SR+ has not yet been translated and validated in Chinese. This study aims to evaluate the psychometric properties of the Chinese translation of the TGI-SR+.

METHODS

We examined the Chinese TGI-SR+'s factor structure, internal consistency, convergent validity, discriminant validity, known-groups validity, and optimal clinical cut-off scores in 443 Chinese bereaved adults.

RESULTS

Confirmatory factor analyses showed that the two-factor models showed the best fit for the Chinese TGI-SR+ items assessing ICD-11 and DSM-5-TR prolonged grief symptoms. Items assessing ICD-11 and DSM-5-TR prolonged grief symptoms demonstrated good internal consistency. Associations of TGI-SR+ scores with symptom levels of prolonged grief (assessed by the International Prolonged Grief Disorder Scale), posttraumatic stress, anxiety, and depression supported convergent and discriminant validity. Associations with background/loss-related variables provided evidence for known-groups validity. Cut-off points for probable ICD-11 PGD (liberal scoring rule), probable ICD-11 PGD (conservative scoring rule), and probable DSM-5-TR PGD were ≥67, ≥75, and ≥68, respectively.

DISCUSSION

The Chinese TGI-SR+ appears to be a reliable and valid measure to assess prolonged grief symptoms per ICD-11 and DSM-5-TR among Chinese bereaved adults.

The Absence of Funeral Rites as a Risk Factor for the French Bereaved Population

During the COVID-19 pandemic, stringent measures were imposed in numerous countries, including France. These measures significantly disrupted societal practices, particularly mourning and funeral rituals. This study, conducted between June and September 2021 as part of the COVIDEUIL-France research, involved 242 participants, predominantly female (84%) with an average age of 49.64 years. The research aimed to investigate the consequences of the absence of funeral rituals and the adoption of personalized, domestic, and digital alternatives. Using online surveys and psychological tools, including the Traumatic Grief Inventory Self Report Version (TGI-SR), General Health Questionnaire-28 (GHQ-28), and Post-traumatic Growth Inventory (PTGI), the study found a significant correlation between the lack of traditional practices and grief complications. Despite 21.81% of participants compensating with personal commemorations, digital commemorations were underutilized, raising questions about their effectiveness. The study provides crucial insights, emphasizing the need to address the psychological effects of disrupted mourning practices in France.

Pandemic Grief and Suicidal Ideation in Latin American Countries: A Network Analysis

This study aimed to characterize the network structure of pandemic grief symptoms and suicidal ideation in 2174 people from eight Latin American countries. Pandemic grief and suicidal ideation were measured using the Pandemic Grief Scale and a single item, respectively. Network analysis provides an in-depth characterization of symptom-symptom interactions within mental disorders. The results indicated that, "desire to die," "apathy" and "absence of sense of life" are the most central symptoms in a pandemic grief symptom network; therefore, these symptoms could be focal elements for preventive and treatment efforts. Suicidal ideation, the wish to die, and the absence of meaning in life had the strongest relationship. In general, the network structure did not differ among the participating countries. It identifies specific symptoms within the network that may increase the likelihood of their co-occurrence and is useful at the therapeutic level.

The Impact of the COVID-19 Pandemic on Self-Harm Attempts Observed in a Hospital Emergency Department

Suicide is a significant public health concern, with one million lives lost to it every year. Suicidal ideation and attempts are markers of high risk. The COVID-19 pandemic has had a negative psychological impact on the population. This study aims to describe and analyze the clinical and sociodemographic characteristics of patients who have received medical attention for self-harm attempts in a hospital emergency department, comparing the period before and after the COVID-19 pandemic. This is a descriptive, retrospective study that collected data from medical records of patients who received care for self-harm attempts in the emergency department. The data included cases from 1 January 2018 to 31 December 2022. In total, 529 cases of self-harm attempts were identified, of which 62.8% were female. The number of post-pandemic self-harm attempts significantly increased compared to the period before the pandemic. The most used method for self-harm was medication ingestion. This study revealed that over one-third of the participants had previously attempted suicide. Most self-harm attempts were made by women in the 10-20 or 41-50 age groups, with a history of psychiatric illness and multiple medications. The study results also highlighted an increase in self-harm attempts during the COVID-19 pandemic.