OnlineMedEd: Psychiatry - Mood Life and Death

Question 1

What is important to know about Kubler-Ross’s stages of the psychology of dying?

Answer 1

They do not go from 1 to 5. You can go through the stages in any order.

Question 2

List Kubler-Ross’s five stages.

Answer 2

• Denial
• Depression
• Bargaining
• Anger
• Acceptance

Question 3

Kubler-Ross’s stages are typically experienced by whom?

Answer 3

Those dying or those who have a loved one dying

Question 4

If someone’s loved one died unexpectedly and violently, then they may develop ________.

Answer 4

PTSD

Question 5

What features suggest a PTSD response to death?

Answer 5

• Anxiety

* Avoidance

Question 6

Summarize the diagnostic criteria of adjustment disorder.

Answer 6

A change in mood after a non-life-threatening event that does not meet the criteria for another disorder (e.g., GAD, PTSD, MDD)

Note: the “non-life-threatening event” cannot be the death of a loved one, otherwise that would be bereavement.

Question 7

What is a handy distinction between normal grief and abnormal depression in a bereaved person?

Answer 7

In normal grief, all of the patient’s symptoms are focused on the loss of the family member. Their depression, suicidality, and hopelessness are all centered around the person who died. (“I might as well not live without my wife!”)

In abnormal depression (or persistent complicated bereavement disorder–PCBD), the focus of the patient’s symptoms is on the patient. (“I want to kill myself because I can’t imagine a happy future and I want to escape these feelings.”)

Question 8

Any depressive symptoms that persist for longer than _____________ are no longer considered normal grieving.

Answer 8

12 months

Question 9

Symptoms that ___________ (a pattern of time) are suggestive of normal grief.

Answer 9

wax and wane

(“I feel okay when I spend time with my friends and children, but when I’m alone I think of how Jim’s gone and I start to feel awful.”)

Question 10

Those with normal grief can have some symptoms that seem like psychosis, but they ___________.

Answer 10

typically have insight into their symptoms (i.e., they know they’re not real) and they’re more commonly the griever talking TO or praying AT or seeing the deceased person (as opposed to the deceased person talking to the griever).

Question 11

Describe the overall pattern of symptoms of PCBD.

Answer 11

Those with PCBD have the focus of grief (that is, they’re focusing on the deceased), but the symptoms of depression (like not being able to imagine a happy future or having psychosis without insight).

Question 12

Baby blues typically occurs with the __________ and mothers usually care about the child.

Answer 12

1st child

In postpartum depression, the mother often doesn’t care about the child.

Question 13

True postpartum depression and psychosis typically starts within ___________ after delivery.

Answer 13

one month

Question 14

Mothers with postpartum psychosis are at risk of _____________.

Answer 14

killing their babies