Problem:
A 56-year-old woman presents to the physician at the request of her daughter. The patient's spouse passed away unexpectedly 14 months ago from a heart attack. She tells you that she has been having a very difficult time since her spouse's death. She has not been sleeping well because she cannot get used to sleeping alone. She no longer enjoys going over to her daughter's house and finds interacting with her grandchildren too tiresome. She says she keeps thinking about the day her spouse died and feels guilty about not being able to get to the hospital sooner. She reports no plans to hurt herself but does say she wonders if she would be better off if she could join her spouse. Which of the following diagnoses is most appropriate? Acute stress disorder Major depressive disorder Normal grief Persistent complex bereavement disorder