Abstract
<jats:p>Background. The growing number of losses due to war, the COVID-19 pandemic, and social crises underscores the need to differentiate between normal and pathological grief. Delayed diagnosis of prolonged grief disorder (PGD) increases the risk of depression, suicidality, and psychosomatic disorders. Objective: to systematize theoretical concepts and empirical research for distinguishing normal and pathological grief, and to analyze the mental health of individuals who lost a loved one due to the full-scale Russian invasion of Ukraine, with a subsequent assessment of potential mental disorders and the effectiveness of modern therapeutic approaches, including pharmacological interventions. Materials and methods. This study integrates a review of scholarly literature from various scientific databases (2014–2024) and findings of own clinical observations. A total of 96 patients aged 25–55 who had experienced a loss were clinically examined. The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) was used for initial scre-ening. 58 patients met the criteria for PGD according to the TGI-SR+ and were further evaluated using the Montgomery-sberg Depression Rating Scale (MADRS) to assess depressive symptoms. Results. PGD was confirmed as a distinct diagnostic category with well-defined criteria. Its core features include persistent emotional suffering, anxiety symptoms, and social maladjustment persisting six months after the loss. The literature review supports the effectiveness of combining psychotherapeutic and pharmacological interventions. In this study, PGD patients were stratified into two subgroups based on MADRS scores: group 1 — moderate depression (n = 31; MADRS 24.42 ± 2.17), group 2 — mild depression (n = 37; MADRS 12.41 ± 2.82). All patients received escitalopram: up to 20 mg in group 1 and up to 10 mg in group 2. One month after treatment initiation, MADRS scores significantly decreased in both groups: to 8.06 ± 1.80 in group 1 and to 4.68 ± 1.48 in group 2 (p < 0.05). Conclusions. A deeper understanding of loss and the grieving process enables timely diagnosis of pathological grief. Under wartime conditions, families of the deceased and mis-sing people often experience intense grief that, when prolonged, can develop into PGD. In such cases, antidepressant support may be appropriate. Escitalopram proved effective in alleviating depressive symptoms associated with PGD.</jats:p>