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Old 03-08-2012
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Psyche PTSD versus normal grief!

There was accident 4 month ago where her husband died. Now she rarely see her friends have frequent bouts of crying, loss of appetite with weight loss from 140 to 125lb. Difficulty sleeping and frequently thinks about her husband and replayin the accident over and over again in her head agonizing what she should have done and she should have
been the one to have died.

a. adjustment disorder
b. dysthymia
c. normal reaction
d. Post traumatic stress disorder
e. psycho fugue
f. unipolar

ans: C
Isn't 4 month too long for normal grief (less than 2 month)?
why not post traumatic disorder?
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Old 03-08-2012
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Default Not perfect answer, but some ideas?

Grief I think can last longer yes.... normal grief as well. She thinks about the accident, if PTSD I think she would have avoided situations which reminds of the accident and also have more flashbacks. It is not dysthemia as she does not feel other feelings despite the constant sadness and also less than 3 years or what it was again...

Sorry for terrible answer with no absolute answer, I haven't gotten this far yet Still on my microbiology
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  #3  
Old 03-08-2012
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No i think normal grief can last up to 6 months....and it wouldn't be PTSD anyways as the interval is too short (it would have been acute stress disorder)
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Old 03-08-2012
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Default

Normal Grief takes upto 6 months - 1 year.

BUT

Consider depression if:

1. Lasts longer than 1 year
2. Sooner than 1 year if symptoms are severe enough
3. loss of self
4. suicidal ideation


In this case it is still normal grief.
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  #5  
Old 03-08-2012
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Default Thanks for sharing the qestion.

Can you please mention the source of the question in the subject line.
So, if it's from a NBME, those of us who haven't taken it can avoid checking the question. It'll mess up our NBME results. Thanks.

I think everyone should have the basic courtesy to adhere to this rule, but very few really do.


Anyways, coming to the question.

I don't think that the answer is correct


Acccording to BRS Behav Sc. 5/e

The characteristics of abnormal grief reaction which match this case are -

Significant weight loss >5% body weight
Intense feelings of guilt
Has not resumed any social activities
and all these symptoms persisting for >2mo

The other symptoms appear equivocal -
sleep disturbance - severity not mentioned

The patient actually shows NO symptoms of normal grief reaction

The patient also meets PTSD criteria vaguely

H/o catastrophic event
Rexperiencing - "frequently thinks about her husband and replayin the accident over and over again in her head"
Hyperarousal - "difficulty sleeping"
Avoidance - social withdrawal "rarely see her friends" & survivor's guilt "agonizing what she should have done and she should have been the one to have died."
(Emotional numbing +/- - "rarely see her friends")


So I think it's pretty clear that this is a very poorly framed question.

Do mention the source please.

Thanks
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