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Prolonged Grief Disorder among Indian Women Widowed by Communal Violence

Mukimulhasan Saiyad, Caroline H Abbott, Alaka Ray, Vankar GK, Arun Kumar, Chetan Patel, Rahul Shidhaye, Seema Garg, Nilesh Bhaiya and Holly G Prigerson

Prolonged Grief Disorder is a common and debilitating condition with diagnostic criteria that have only recently been proposed and tested, primarily in the United States. Widows who had lost their husbands in communal riots in 2002 in India were evaluated for Prolonged Grief Disorder (PGD) using validated diagnostic criteria. Of the 110 widows studied, 24 (21.8%) met criteria for PGD, 60 (54.5%) met criteria for major depressive disorder (MDD) and 33 (30.0%) met criteria for posttraumatic stress disorder (PTSD). Phi coefficients revealed some modest overlap between diagnoses; PGD and MDD: phi=0.261; PGD and PTSD: phi=0.375; MDD and PTSD: phi=0.398. A minority (37.3%) of the women did not meet criteria for any of the assessed mental disorders. Self-reported emotional impact of trauma and having another family member injured in the riots were present more frequently among women with PGD compared to women with MDD and PTSD, respectively (p<0.05). Compared with widows without PGD, widows with PGD had the highest mean levels of disability and psychiatric distress, including suicidality, with 75% reporting suicidal ideation. Muslim women reported significantly (p<0.05) more global distress than Hindu women, indicating a need for future research on cultural and religious influences on widowhood. PGD is a significant problem among Indian widows who survived communal violence.