Now, researchers from Denmark have shown that bereaved people with persistent high levels of intense grief used more health care services and were more likely to die within 10 years. The results are published in Frontiers in Public Health.
“This is the first study to investigate the long-term use of health care and patterns of mortality over a decade after bereavement in a large-scale cohort,” said Dr. Mette Kjærgaard Nielsen, a postdoctoral researcher at the Research Unit for General Practice in Aarhus, Denmark, and the study’s corresponding author.
Previously, Nielsen et al. had identified five common trajectories among this cohort, based on changes in the intensity of grief symptoms over the first three years after losing a loved one. They measured this with the tried-and-tested “Prolonged Grief-13” (PG-13) questionnaire, which assesses symptoms through 13 questions.
People on the low trajectory (38%) displayed persistently low levels of grief symptoms, while 6% followed a high trajectory with persistently elevated levels. Three other categories lay between these extremes: 18% and 29% followed a “high but decreasing” and a “moderate but decreasing” trajectory, respectively, and 9% followed a late-onset trajectory, with a peak of symptoms around six months after bereavement.
In the present study, the researchers extended their follow-up of the participants for a total of 10 years until 2022, except for those who died or emigrated earlier. To do so, the team used data from the Danish National Health Service Register to assess how often each participant received talk therapy from a GP or specialist, or was prescribed any psychotropic medication. Records from the Danish Registry of Causes of Deaths gave information on deaths from any cause.
Differences in the frequency of use of these health care services between the five trajectories were no longer significant after the first eight years, but the excess mortality of participants on the high trajectory remained pronounced over the full 10 years of follow-up.
“We have previously found a connection between high grief symptom levels and higher rates of cardiovascular disease, mental health problems, and even suicide. But the association with mortality should be further investigated,” said Nielsen.
“The ‘high grief’ group had lower education on average, and their more frequent use of medication before bereavement suggested that they had signs of mental vulnerability, which may cause greater distress on bereavement,” said Nielsen.
“A GP could look for previous signs of depression and other severe mental health conditions. They can then offer these patients tailored follow-up in general practice, or refer them to a private-practice psychologist or secondary care. The GP may also suggest a bereavement follow-up appointment focusing on mental health,” suggested Nielsen.
Source:
https://medicalxpress.com/news/2025-07-intense-persistent-grief-linked-mortality.html#
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