Association between prolonged grief symptoms and chronic diseases in adults: A case-control study

This case-control study (N = 400; cases 200, matched controls 200) evaluated the independent association between prolonged grief and chronic disease status in adults. By employing a rigorous statistical framework involving 1:1 propensity score matching, frequentist Firth-penalized regression, and Bayesian multivariable modeling, the study successfully addressed selection bias and mathematical instability inherent in cross-sectional data. The analysis identified the Cultural Supplement: Accessory items (CSAI) total as a robust, independent predictor of chronic disease (crude Odds ratio [OR]: 1.57, adjusted OR: 1.74; matched OR: 1.73; Bayesian OR: 1.61, E-value: 1.97), whereas the International Prolonged Grief Disorder Scale (IPGDS) sub-scales did not retain independent significance after multivariable adjustment. These findings provide strong empirical evidence that elevated prolonged grief symptoms are significantly correlated with physical morbidity independent of baseline demographic and physiological characteristics, emphasizing the clinical necessity of integrating standardized psychosocial screening into long-term chronic disease management.