A 45-year-old man recently bereaved of his wife three weeks ago is tearful, sleeps badly and says he sometimes hears her voice. He functions at work and denies thoughts of self-harm. How should this be regarded?

Answer and explanation

Correct answer: A. A normal grief reaction needing support, with review if it persists or worsens

  1. Step 1: Transient hallucinations of the deceased are common in normal bereavement.
  2. Step 2: Support and monitoring are appropriate, and medication is not indicated at this stage.
Answer
A normal grief reaction needing support, with review if it persists or worsens.
Why not the others: Severe depression, needing admission to a psychiatric ward: Functioning at work without suicidal ideas argues against severe depression. Mania, needing treatment with lithium and a mood diary: There is no elevated mood, pressured speech or reduced need for sleep. Schizophrenia, needing treatment with an antipsychotic drug: Brief hearing of a lost loved one's voice is not schizophrenia.

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