DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
|
B. Beravement or E. Major Depression?
Husband died 4 years ago = normal grief
Suicidal Thoughts = dangerous? = Major depression?
24 lb weight loss in 4 weeks! = Too much! –Depressed?
.......
Attached Files:
6.2.JPG (81 KB, 99 downloads)
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,123
|
E
___________________
The Key to Succeed is Patience.
|
| gr8doc
Forum Senior
Topics: 8
Posts: 210
|
E.
SWAG - MDD.
|
| Drtweetie
Forum Elite
Topics: 17
Posts: 301
|
Doesn't the diagnosis for major depressive disorder requires depressive episode to continue at least >2 wks, w/ at least 2 or more episodes separated by at least 2 months?
I agree that she fits 5 of the 9 SIGECAPSS criteria for MDD, but the duration is not enough, but her husband just passed away, the symptoms that a person in bereavement are similar to depression. I think they want us to remember the timing and duration definition of MDD.
___________________
"Our greatest glory is not in never falling but in rising every time we fall." --Confucius
|
| gr8doc
Forum Senior
Topics: 8
Posts: 210
|
As far as I know If a patient shows any one of the SWAG ( suicidal ideation, Weight loss in excess of 10%,anhedonia & guilt ) it is labelled as MDD regardless of the duration.
Correct me if I'm wrong.
|
| cirus
Forum Guru
Topics: 108
Posts: 740
|
gr8doc wrote:
As far as I know If a patient shows any one of the SWAG ( suicidal ideation, Weight loss in excess of 10%,anhedonia & guilt ) it is labelled as MDD regardless of the duration.
Correct me if I'm wrong.
In Beravement, pts may have some suicidal thoughts..
Ill go for Beravement (+ve cause & sympt for 2 ms)
|
| gr8doc
Forum Senior
Topics: 8
Posts: 210
|
Yes I agree Cirus that even in Bereavement there are suicidal thoughts but these thoughts are related only in the context that the person wishes that s/he should have been dead instead of the deceased & the suicidal thoughts are limited to that only.
Here's what the DSM-IV says about bereavement.
V62.82 Bereavement(Also called "normal grief")
This category can be used when the focus of clinical attention is a reaction to the death of a loved one. As part of their reaction to the loss, some grieving individuals present with symptoms characteristic of a Major Depressive Episode (e.g. feelings of sadness and associated symptoms such as insomnia, poor appetite, and weight loss). The bereaved individual typically regards the depressed mood as "normal," although the person may seek professional help for relief of associated symptoms such as insomnia or anorexia.
The duration and expression of "normal" bereavement vary considerably among different cultural groups. The diagnosis of Major Depressive Disorder is generally not given unless the symptoms are still present 2 months after the loss.
However, the presence of certain symptoms that are not characteristic of a "normal" grief reaction may be helpful in differentiating bereavement from a Major Depressive Episode. These include
guilt about things other than actions taken or not taken by the survivor at the time of the death;
thoughts of death other than the survivor feeling that he or she would be better off dead or should have died with the deceased person;
morbid preoccupation with worthlessness;
marked psychomotor retardation;
prolonged and marked functional impairment, and
hallucinatory experiences other than thinking that he or she hears the voice of or transiently sees the image of, the deceased person.
Source: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorder. Fourth Edition. Washington DC, American Psychiatric Association, 1994, page 684-685.
|
| radonc
Forum Senior
Topics: 10
Posts: 180
|
I think this is major depressive disorder. Bereavement is considered 'normal'. This patient's behaviour or grieving is NOT normal. She is not eating and wants to kill herself!
|
| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
|
I am leaning toward MDD also
(E)
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
| Ivonne
Find a way or make one
Topics: 58
Posts: 1,611
|
I think this question is trying to evaluate the difference between normal grief reaction(Bereavement) and abnormal grief reaction (Depression).
Definetely (E) MDD
1.-Patients with bereavement attempt to return to work and social activities while this patient just lies in bed and cries
2.-This is a case of major weight loss (24 lb), normal grief(1-3lb)> This patient may have potencially a sever desnutrition as shown by her albumin and total protein levels.
3.-Timing: severe symptoms in Normal grief resolve within 2 months
___________________
92/99/pass/ECFMG certified/4 US LoRs/GC/extensive USCE/2004 grad/appl 29 IM Prog, IV/Rej: 3/0 "I must, I can and I will"
|
| elitoki
Forum Guru
Topics: 54
Posts: 508
|
I think answer is E.
Normal grief is similar to depression but it is less severe.
This pte has severe lost weight , ideal of suicide....
She needs to be treated now.
|
|
| |
| | | | | | | | | | | |
