Can Prolonged Grief Disorder and PTSD Be Comorbid for the Same Trauma?
Yes, prolonged grief disorder (PGD) and PTSD can absolutely be comorbid following the same traumatic loss, and this co-occurrence is common rather than exceptional.
Prevalence and Co-occurrence
- Among traumatically bereaved individuals, 49% develop prolonged grief disorder, and 65% of bereaved patients referred to psycho-trauma clinics experience prolonged grief symptoms alongside posttraumatic stress symptoms 1
- Traumatic loss—where death occurs under potentially traumatizing circumstances—commonly gives rise to both disturbed grief (PGD) and PTSD, often combined with depression 2
- The intersection of traumatic events and losses creates conditions where both disorders can be triggered simultaneously, as the same event involves both trauma exposure and bereavement 3
Why Both Disorders Can Coexist
The diagnostic criteria for these conditions address different symptom clusters that can arise from the same traumatic loss event:
- PTSD symptoms focus on intrusion (distressing memories, nightmares, flashbacks), avoidance of trauma reminders, negative alterations in cognitions and mood, and increased arousal/reactivity that persist for at least 1 month 4
- PGD symptoms center on grief-specific reactions including yearning for the deceased, preoccupation with the loss, and difficulties accepting the death 2, 5
- These represent distinct but overlapping psychological responses—one focused on the traumatic nature of the event itself, the other on the loss of the relationship 5
Bridge Symptoms and Shared Features
- Symptoms related to social isolation and diminished sense of self were identified as bridge symptoms connecting the comorbidity between prolonged grief and posttraumatic stress 1
- Both disorders share common risk factors including lack of social support and difficulties with social emotions 3
- However, certain factors appear more specific: the relationship to the deceased, pre-existing mental health issues, and religious beliefs seem more strongly associated with pathological grief compared to PTSD symptoms 3
Clinical Implications for Treatment
- Trauma-focused treatments can effectively address both PTSD and PGD concurrently without requiring separate interventions or prolonged stabilization phases 6, 7
- Treatments are generally effective in reducing symptoms of both disorders simultaneously, with exposure-based and non-exposure-based approaches showing similar efficacy 8
- Clinicians must actively screen for prolonged grief symptoms in trauma-exposed patients to adequately capture the full psychopathology among those affected by trauma and loss 1
Common Pitfall to Avoid
Do not assume that treating PTSD alone will resolve grief symptoms, or vice versa—while there is symptom overlap and shared treatment mechanisms, both conditions require clinical attention and may need grief-specific interventions alongside trauma-focused treatment 2, 8. The co-occurrence rate of 65% means that most traumatically bereaved patients presenting with one disorder likely have the other 1.