Prolonged grief reaction Flashcards
Define adjustment disorder and prolonged grief reaction?
AD: Prolonged severe abnormal repsonse to stress beginning within 1m of stressful episode and lasting no longer than 6months
PGR: Abnormal prolonged repsonse to grief. Normal grief onset within a few days and lasts over 2 years, with initial response of anger, guilt, self blame, and later pining, despair and sadness. Abnormal responses include delayed or prolonged response.
What are risk factors for prolonged grief reaction?
Maladaptive psychological processing.
Summarise the epidemiology of adjustment disorder and prolonged grief reaction.
PGR: Usually occurs with sudden and unexpected deaths. May have problems in relationships leading to processing difficulties, or being unable to grieve due to putting on brave face.
What are the signs and symptoms of adjustment disorder and prolonged grief reaction?
AD: Precipitated by stressor. Patient has symptoms of anxiety, depression, irritability, insomnia, low mood. No biological features of depression (i.e. apetite changes). Adjustment to terminal illness may follow a similar course. May have high autonomic arousal.
PGR: Hx of difficult relationship, symptoms such as shock, disbelief, anger, sadness and despair may be severe, May feel depressed or have suicidal thoughts.
What is the management for a prolonged grief reaction?
AD: Remove stressor. Supportive psychotherapy, coping mechanisms.
PGR: Bereavement counselling, CBT, suicide risk assess.
What are complications for adjustment disorder and prolonged grief reaction?
AD: Disrupt work and social life, symptoms usually improve rapidly.
PGR: Depresison, substance abuse, suicide. Most improve with treatment.