Complicated grief (CG) is currently under consideration for inclusion in DSM-V and a major issue is whether it can be differentiated from major depression (MDD) and post-traumatic stress disorder (PTSD).

There is evidence on the role of childhood but not separation anxiety as a significant risk factor for CG, and no study compared CG and PTSD patients with respect to these features.

To compare adult separation anxiety in patients with PTSD versus CG or both conditions. Further, to investigate the possible impact of mood spectrum symptoms in the same samples.

A total sample of 116 patients (66 PTSD, 22 CG and 28 with CG+PTSD) was recruited. Assessments included: the SCID-I/P, the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA-27), the Work and Social Adjustment Scale (WSAS) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.

CG was strongly associated with female gender (8:1). MDD comorbidity was more common among patients with CG while bipolar disorder was highest among those with PTSD+CG. Patients with both CG and PTSD reported significantly higher ASA_27 (p = 0.008) scores than patients with either CG or PTSD alone. Patients with both diagnoses or PTSD alone reported significantly (p = 0.02) higher scores on the manic component of the MOODS-SR. No significant differences were reported in the WSAS scores.

Our results support differences between CG and PTSD, important to consideration of including CG as a new disorder in DSM-V.