An elderly house wife lost her husband who died suddenly of Myocardial infarction couple of years ago. They had been staying alone for almost a decade with infrequent visits from her son and grandchildren. About a week after the death she heard his voice clearly talking to her as he would in a routine manner from the next room. She went to check but saw nothing. Subsequently she often heard his voice conversing with her and she would also discuss her daily matters with him. This however, provoked anxiety and sadness of mood when she was preoccupied with his thought. She should be treated with:
D i.e. HaloperidolThe diagnosis of this lady is morbid grief When there is an exaggeration of one or more symptoms of normal grief or the duration becomes prolonged beyond 6 months without recovery, it is k/a morbid grief.Preoccupation with the memory of deceased is a characteristic featureQ.Idealization of deceased (ignoring his negative qualities).Sense of presence of deceased in the surroundings & misinterpretation of voices or faces of others as that of lost person. Rarely fleeting hallucinations may occur.Treatment - In morbid & complicated grief, medication depends on presenting clinical features.As this lady is mainly having problem of auditory hallucination (1/t sadness & anxiety) - antipsychotic like haloperidol is needed to treat her.
Clornipramine.
Aiprazolam
Electroconvulsive therapy.
Haloperidol.