Physical symptoms in prolonged grief disorder: a case report

Area of Science:

• Psychiatry
• Psychology
• Grief Research

Background:

• Prolonged grief disorder (PGD) was recognized in the DSM-5-TR in 2022, characterized by intense yearning and preoccupation with the deceased.
• While not diagnostic criteria, somatic symptoms can co-occur with PGD.
• Facsimile illness, where an individual experiences physical symptoms similar to a deceased loved one, presents a unique challenge in grief counseling.

Observation:

• A patient developed physical symptoms mirroring her deceased husband's brain tumor, including headaches and hypertension, following his death.
• The patient's symptoms were consistent with facsimile illness, a rare manifestation of grief.
• The case involved a patient experiencing intense grief and somatic complaints.

Findings:

• The dual process model of grief, emphasizing oscillation between loss-oriented and restoration-oriented activities, was applied.
• Outpatient psychotherapy incorporating exposure therapy and behavioral activation based on the dual process model was implemented.
• The patient's physical symptoms significantly improved following the intervention.

Implications:

• This case highlights the importance of recognizing and addressing physical symptoms in bereavement.
• The dual process model, through exposure and behavioral activation, offers a viable therapeutic approach for facsimile illness.
• Clinicians should consider somatic symptoms as a potential manifestation of complicated grief and facsimile illness.