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Background: Violent loss (i.e. loss through homicide, suicide, or accident) is associated with high levels of prolonged grief disorder (PGD). Objective: The current meta-analysis aims at identifying correlates of PGD in adults exposed to violent loss. Method: We conducted a systematic literature search in PsycINFO, PsycARTICLES, PubMed, Web of Science, and Scopus. We used the Pearson correlation coefficient r as an effect size measure and a random effects model was applied to calculate effect sizes. Results: Thirty-seven eligible studies published between 2003 and 2017 (N = 5911) revealed 29 potential correlates. Most studies used a cross-sectional design. Analyses revealed large significant effect sizes for comorbid psychopathology (r = .50-.59), suicidality (r = .41, 95% confidence interval [CI] [.30; .52]), and rumination (r = .42, 95% CI [.31; .52]), while medium effect sizes were found for exposure to traumatic events and factors concerning the relationship to the deceased. Small effect sizes emerged for sociodemographic characteristics, multiple loss, physical symptoms, and religious beliefs. Ten variables did not show a significant association with PGD. Heterogeneity and a small number of studies assessing certain correlates were observed. Conclusions: The associations with psychological disorders may indicate shared mechanisms of psychopathology. Moreover, we recommend that clinicians carefully assess suicidal ideation among individuals with PGD who have been exposed to violent loss. Further research is warranted using longitudinal study designs with large sample sizes to understand the relevance of these factors for the development of PGD.

Prolonged Grief Disorder (PGD) is a new disorder. A structured clinical interview for ICD-11 and DSM-5-TR PGD is a necessary tool in diagnosing PGD needed as PGD is implemented as a mental disorder in health services across the world. This study developed and validated The Aarhus PGD Interview (A-PGDi) to provide clinicians with free access to a valid method to diagnose PGD in alignment with recent diagnostic requirements in ICD-11 and DSM-5-TR and to training materials. The A-PGDi was developed in close collaboration between scientists, clinicians, and bereaved individuals. First, all PGD-symptoms underwent two rounds of item-formulations by clinicians and researchers. Then, a first version of the A-PGDi was tested in a group of bereaved adults with PGD symptoms, who were interviewed about the A-PGDi. The A-PGDi was refined according to their responses, piloted in 13 bereaved adults and further refined to its final version. The validity of A-PGDi was then tested with clinical interviews for PGD, PTSD, depression, and anxiety performed by carefully trained clinical interviewers in a sample of 124 bereaved adults (mean age 47 years (range 19-83 years); 85% female). Benchmarked against a self-report measure of PGD and moderate to substantial inter-diagnostic agreement between ICD-11 and DSM-5-TR diagnoses the A-PGDi had sufficient content validity. Significant relations between PGD-diagnosis and other mental disorders estimated with clinical interviews and self-report scales and moderate to substantial inter-diagnostic and test-retest agreement indicated sufficient criterion validity and reliability. small non-probability sample with PGD symptoms; self-identified for participation; mostly female. The results indicate that A-PGDi with some limitations is a valid structured clinical interview for diagnosing both ICD-11 and DSM-5-TR PGD that is relevant to administer in mental health settings to ensure correct diagnostics and the most helpful treatment plan for people with PGD.

Background: China has the largest population of '\"loss-of-only-child' parents, that are also known as Shidu parents in Chinese society; however, little is known about their unresolved grief. Objective: This is the first study to examine the grief symptoms, prevalence, comorbidity and potential predictors of prolonged grief disorder (PGD) in such parents, taking into consideration that the new PGD diagnostic criteria ICD-11 will soon be implemented in China. Methods: 149 Shidu parents completed assessments of PGD (PG-13), PTSD (PCL-C), depression (CES-D) and general psychiatric morbidity (GHQ-12) via in-person interviews. Results: Of the 149 Shidu parents, 22.2% met the PGD criteria, with a mean of 7.59 years post-loss, and 62.4% experienced daily longing or yearning. Regression analysis indicated that fewer years since loss, subjective perception of poor economic situation, female gender and more hospital visits were prominent risk factors for the development of PGD. Older age of the parents at the time of child loss was also associated with PGD. Parents with PGD had higher comorbidity of PTSD or depression compared with those without PGD. Conclusions: There is a high prevalence of PGD and a high rate of comorbidity between PGD and PTSD or depression in Shidu parents in China, which highlights the need of timely developing effective assessments and interventions to prevent PGD in this population, particularly in female, recently bereaved, low-income and aged parents who lost their only child.

A new mental health disorder, prolonged grief disorder (PGD), will be included in the 11th edition of the International Classification of Diseases (ICD-11). We provide a brief overview of the historical conceptualizations of disordered grief and the previous research efforts to assess and define this condition. We describe the new ICD-11 PGD symptom criteria and how they are conceptualized in terms of the World Health Organization's call for improved clinical utility. Finally, we review the research evidence for the clinical utility of the new ICD-11 PGD symptom structure and usability in the international arena.

Background Prostaglandin D 2 (PGD 2 ) signaling via prostaglandin D 2 receptor 2 (DP 2 ) contributes to atopic and non-atopic asthma. Inhibiting DP 2 has shown therapeutic benefit in certain subsets of asthma patients, improving eosinophilic airway inflammation. PGD 2 metabolites prolong the inflammatory response in asthmatic patients via DP 2 signaling. The role of PGD 2 metabolites on eosinophil and ILC2 activity is not fully understood. Methods Eosinophils and ILC2s were isolated from peripheral blood of atopic asthmatic patients. Eosinophil shape change, ILC2 migration and IL-5/IL-13 cytokine secretion were measured after stimulation with seven PGD 2 metabolites in presence or absence of the selective DP 2 antagonist fevipiprant. Results Selected metabolites induced eosinophil shape change with similar nanomolar potencies except for 9α,11β-PGF 2 . Maximal values in forward scatter of eosinophils were comparable between metabolites. ILC2s migrated dose-dependently in the presence of selected metabolites except for 9α,11β-PGF 2 with EC 50 values ranging from 17.4 to 91.7 nM. Compared to PGD 2 , the absolute cell migration was enhanced in the presence of Δ 12 -PGD 2 , 15-deoxy-Δ 12,14 -PGD 2 , PGJ 2 , Δ 12 -PGJ 2 and 15-deoxy-Δ 12,14 -PGJ 2 . ILC2 cytokine production was dose dependent as well but with an average sixfold reduced potency compared to cell migration (IL-5 range 108.1 to 526.9 nM, IL-13 range: 125.2 to 788.3 nM). Compared to PGD 2 , the absolute cytokine secretion was reduced in the presence of most metabolites. Fevipiprant dose-dependently inhibited eosinophil shape change, ILC2 migration and ILC2 cytokine secretion with (sub)-nanomolar potencies. Conclusion Prostaglandin D 2 metabolites initiate ILC2 migration and IL-5 and IL-13 cytokine secretion in a DP 2 dependent manner. Our data indicate that metabolites may be important for in vivo eosinophil activation and ILC2 migration and to a lesser extent for ILC2 cytokine secretion.

Several studies have shown that interpersonal dependency is a risk factor for prolonged grief disorder (PGD), a disorder that has been recently approved by the American Psychiatric Association Assembly for inclusion in the Diagnostic and Statistical Manual of Mental Disorders—5—Text Revision (DSM-5-TR). Nevertheless, it remains unclear whether this relationship is independent of depression, which may also be related to both loss and interpersonal dependency. Furthermore, anaclitic dependency (maladaptive and immature) compared to relatedness (more adaptive and mature) dependency, and the relationships between these types of dependency and PGD, have not been examined. The aim of the present study was to determine how anaclitic and relatedness dependency are associated with PGD symptom severity, controlling for depressive symptom severity, over and above potential sociodemographic and loss-related confounder variables. Participants (N = 241) bereaved after the death of a family member from 0.5 to 8 years before the survey (M = 3.36, SD = 2.02) completed the Depressive Experiences Questionnaire, the Patient Health Questionnaire—9, and the Prolonged Grief Disorder—13 scale (PG-13). A hierarchical regression analysis confirmed that anaclitic dependency is positively associated with PGD symptom severity, even when controlling for depression severity and other potential confounder variables. There was no significant association between relatedness dependency and PGD. To assess the risk of PGD in individuals bereaved after the death of a family member, it is important to assess anaclitic dependency. •Anaclitic dependence is positively associated with PGD symptom severity.•There was no significant association between relatedness (i.e., more mature dependency) and PGD.•These associations remained when controlling for severity of depressive symptoms.

Prostaglandins (PGs) are a family of lipid compounds that are derived from arachidonic acid via the cyclooxygenase pathway, and consist of PGD2, PGI2, PGE2, PGF2, and thromboxane B2. PGs signal through G-protein coupled receptors, and individual PGs affect allergic inflammation through different mechanisms according to the receptors with which they are associated. In this review article, we have focused on the metabolism of the cyclooxygenase pathway, and the distinct biological effect of each PG type on various cell types involved in allergic airway diseases, including asthma, allergic rhinitis, nasal polyposis, and aspirin-exacerbated respiratory disease.

Background Bereaved ICU family surrogates are at risk of comorbid prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Knowledge about temporal relationships between PGD, PTSD, and depression is limited by a lack of relevant studies and diverse or inappropriate assessment time frames given the duration criterion for PGD. We aimed to determine the temporal reciprocal relationships between PGD, PTSD, and depressive symptoms among ICU decedents’ family surrogates during their first 2 bereavement years with an assessment time frame reflecting the PGD duration criterion. Methods This prospective, longitudinal, observational study examined PGD, PTSD, and depressive symptoms among 303 family surrogates of ICU decedents from two academic hospitals using 11 items of the Prolonged Grief Disorder-13, the Impact of Event Scale—Revised, and the depression subscale of the Hospital Anxiety and Depression Scale, respectively, at 6, 13, 18, and 24 months post-loss. Cross-lagged panel modeling was conducted: autoregressive coefficients indicate variable stability, and cross-lagged coefficients indicate the strength of reciprocal relationships among variables between time points. Results Symptoms (autoregressive coefficients) of PGD (0.570–0.673), PTSD (0.375–0.687), and depression (0.591–0.655) were stable over time. Cross-lagged standardized coefficients showed that depressive symptoms measured at 6 months post-loss predicted subsequent symptoms of PGD (0.146) and PTSD (0.208) at 13 months post-loss. PGD symptoms did not predict depressive symptoms. PTSD symptoms predicted subsequent depressive symptoms in the second bereavement year (0.175–0.278). PGD symptoms consistently predicted subsequent PTSD symptoms in the first 2 bereavement years (0.180–0.263), whereas PTSD symptoms predicted subsequent PGD symptoms in the second bereavement year only (0.190–0.214). PGD and PTSD symptoms are bidirectionally related in the second bereavement year. Conclusions PGD, PTSD, and depressive symptoms can persist for 2 bereavement years. Higher PGD symptoms at 6 months post-loss contributed to the exacerbation of PTSD symptoms over time, whereas long-lasting PTSD symptoms were associated with prolonged depression and PGD symptoms beyond the first bereavement year. Identification and alleviation of depression and PGD symptoms as early as 6 months post-loss enables bereaved surrogates to grieve effectively and avoid the evolution of those symptoms into long-lasting PGD, PTSD, and depression.

Reciprocal translocations (RecT) and Robertsonian translocations (RobT) are among the most common chromosomal abnormalities that cause infertility and birth defects. Preimplantation genetic testing for aneuploidy using comprehensive chromosome screening for in vitro fertilization enables embryo selection with balanced chromosomal ploidy; however, it is normally unable to determine whether an embryo is a translocation carrier. Here we report a method named “Mapping Allele with Resolved Carrier Status” (MaReCs), which enables chromosomal ploidy screening and resolution of the translocation carrier status of the same embryo. We performed MaReCs on 108 embryos, of which 96 were from 13 RecT carriers and 12 were from three RobT carriers. Thirteen of the sixteen patients had at least one diploid embryo. We have confirmed the accuracy of our carrier status determination in amniotic fluid karyotyping of seven cases as well as in the live birth we have thus far. Therefore, MaReCs accurately enables the selection of translocation-free embryos from patients carrying chromosomal translocations. We expect MaReCs will help reduce the propagation of RecT/RobT in the human population.