{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:55:26Z","timestamp":1790664926859,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":270,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["T2341003"],"award-info":[{"award-number":["T2341003"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Depression and Anxiety"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prolonged grief disorder (PGD) impairs psychophysiological well\u2010being and social functioning. Although post\u2010death grief trajectories have been well\u2010documented, pre\u2010death grief trajectories remain understudied, particularly within the same cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This exploratory pilot study aimed to identify candidate longitudinal trajectories of grief before and after bereavement and to examine their associations with subsequent mental health outcomes, with the goal of generating hypotheses to inform a larger confirmatory cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study was conducted at Peking Union Medical College Hospital. Participants were adult immediate family members of terminally ill patients with a life expectancy of 6 months or less enrolled between October and December 2023. Grief, depression, anxiety and stress were measured using the Anticipatory Grief Scale (AGS) and the PGD\u201013 Revised (PG\u201013\u2010R), the 17\u2010item Hamilton Rating Scale for Depression (HAMD\u201017), the Hamilton Anxiety Scale (HAMA) and the Impact of Event Scale\u2010Revised (IES\u2010R), at baseline, monthly before bereavement and quarterly for 6 months after bereavement, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 60 participants (mean [SD] age, 52.82 [10.18%] years; 32 [53.3%] women) were enrolled, most were offspring of terminally ill patients (44 [73.3%]). Two pre\u2010death grief trajectories (Low,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951 [85%]; and increasing,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099 [15%]) and four post\u2010death grief trajectories (high\/decreasing,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099 [15%]; moderate\/decreasing,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200926 [43.33%]; low\/decreasing,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915 [25%]; and high\/prolonged,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910 [16.67%]) were identified. At the final visit, the incidences of PGD, depressive disorders, anxiety disorders and stress\u2010related disorders were 16.7%, 16.7%, 30.0% and 0%, respectively. Participants in the Increasing pre\u2010death grief trajectory and the persistently high\/prolonged post\u2010death grief trajectory had higher incidences of PGD, depressive disorders, and anxiety disorders compared to other groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individuals experiencing increasing pre\u2010death grief or persistently high\u2010level post\u2010death grief are more likely to develop PGD and other mental disorders. Findings are exploratory and require replication in a larger, theoretically informed cohort.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Chinese Clinical Trial Registry Identifier: ChiCTR2300071236\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/da\/5274616","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:56:46Z","timestamp":1790661406000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Trajectories of Grief Before and After Bereavement and Their Association With Mental Health Outcomes: A Pilot Prospective Cohort Study From the China Grief Cohort 2025"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5681-6584","authenticated-orcid":false,"given":"Chunfeng","family":"Xiao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5238-6271","authenticated-orcid":false,"given":"Song","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8050-3796","authenticated-orcid":false,"given":"Xinpeng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4065-0898","authenticated-orcid":false,"given":"Wentao","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7269-1088","authenticated-orcid":false,"given":"Yufei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8167-9075","authenticated-orcid":false,"given":"Jing","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163221074540"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2016.0136"},{"key":"e_1_2_12_3_2","unstructured":"BolbyJ. 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