Background: China has the largest population of '"loss-of-only-child' parents, that are also known as Shidu parents in Chinese society; however, little is known about their unresolved grief. Objective: This is the first study to examine the grief symptoms, prevalence, comorbidity and potential predictors of
prolonged grief disorder (
PGD) in such parents, taking into consideration that the new
PGD diagnostic criteria ICD-11 will soon be implemented in China. Methods: 149 Shidu parents completed assessments of
PGD (PG-13),
PTSD (PCL-C), depression (CES-D) and general psychiatric morbidity (GHQ-12) via in-person interviews. Results: Of the 149 Shidu parents, 22.2% met the
PGD criteria, with a mean of 7.59 years post-loss, and 62.4% experienced daily longing or yearning. Regression analysis indicated that fewer years since loss, subjective perception of poor economic situation, female gender and more hospital visits were prominent risk factors for the development of
PGD. Older age of the parents at the time of child loss was also associated with
PGD. Parents with
PGD had higher comorbidity of
PTSD or depression compared with those without
PGD. Conclusions: There is a high prevalence of
PGD and a high rate of comorbidity between
PGD and
PTSD or depression in Shidu parents in China, which highlights the need of timely developing effective assessments and interventions to prevent
PGD in this population, particularly in female, recently bereaved, low-income and aged parents who lost their only child.