9–20% of subjects facing bereavement may develop symptoms of unresolved grief associated with significant distress and impairment that have been recently identified as a distinct post-loss syndrome named complicated grief (CG). Aim of this study was to: 1) explore anxiety, adult separation distress and panic spectrum symptoms in CG; 2) correlate these symptoms with social and occupational impairment 3) provide additional evidence of complicated grief diagnosis through analysis of CG symptoms in a clinical data set consisting of bereaved individuals with CG, Post-Traumatic Stress Disorder (PTSD) and healthy controls (HTC).

201 bereaved subjects were consecutively enrolled: 72 with CG; 78 with PTSD; 51 HTC. Assessments included: the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I/P), the Italian version of the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA_27), the Panic-Agoraphobic Spectrum-Self-Report (PAS-SR) and the Work and Social Adjustment Scale (WSAS).

CG patients reported a significantly (p<.001) higher scores in the ASA_27 compared to PTSD patients and HTC. Moreover, CG patients reported significantly higher total PAS scores compared to PTSD patients and HTC. When we analyzed the single PAS domains, we found a statistical difference for CG versus PTSD in regard to separation sensitivity (I), panic-like symptoms (II), stress sensitivity (III) and anxious expectation (V). Only in CG patients, higher ASA_27 scores correlated with greater functional impairment.

This study shows how anxiety separation is a core symptom of CG and provides additional medical evidence on the proposition that CG is an independent diagnosis.