Bereavement

Question 1

Depression

Answer 1

• one third of those who lose a spouse meet criteria for major depression in the first month after the death
• half remain clinically depressed 1 year later

Question 2

Treatment of depression in bereavement

Answer 2

-should be initiated earlier in patients with suicidal ideation, severe functional impairment, prior history of depression or other signs of severe depression

Question 3

Elderly bereavement

Answer 3

-in first year of bereavement 10-20% of surviving spouses develop symptoms of depression that require treatment

Question 4

Coping

Answer 4

• older people are felt to be better able to cope with bereavements
• less likely to become depressed than young people in the first months
• major depression rates are similar in all ages by the end of the second year

Question 5

Normal grief reaction

Answer 5

Phase 1: shock and protest
Phase 2: preoccupation
Phase 3: disorganisation (despair and acceptance of loss)
Phase 4: resolution

Question 6

Time period for normal grief reaction

Answer 6

• improvements expected within 2 to 6 months

- those who meet criteria for major depression after this time period should be treated

Question 7

Inhibited grief

Answer 7

-absence of expected grief symptoms at any stage

Question 8

Delayed grief

Answer 8

-avoidance of painful symptoms within 2 weeks of loss

Question 9

Chronic grief

Answer 9

-continued significant grief related to symptoms 6 months after loss

Question 10

Prevalence of major depression

Answer 10

• continues to increase during the second year of bereavement
• by the end of the second year 14% of bereaved individuals have major depression compared with 1-4% of elderly population