You probably don't need to know this for Step 1. If they ask it, which is unlikely, it'll be pretty obvious.
Pathologic grief = Complicated grief/Abnormal bereavement = Persistent complex bereavement disorder (the new DSM-V name)
That narrows it down to really 3 entities in your original post. I've highlighted the differences below:
-Normal grief vs. MDD: Differentiated by
severity of symptoms. This is the tough one.
- A patient who is psychotic or suicidal is likely to have MDD no matter how quick after the inciting event occurs, even though both can less commonly occur in grief.
- Also, if they meet 5 of the SIGECAPS requirements for depression, then you can also diagnose MDD. However the USMLE will never make you actually count 5 symptoms...they'll give you a big list of symptoms to show that a person is really suffering -- "patient has lost 20 pounds, hasn't gone outside in a week, etc.".
- If a focus on the loss exists in the person's sadness, it's more likely to be grief. If they feel worthless and want to die without specifically stating it's because of the inciting event, it's more likely to be MDD.
-Normal grief vs. pathologic grief: Differentiated by
length of symptoms. If it's going on for >12 months, it's pathological grief. That's it.
Again, they won't get into this on Step 1, but Step 2 definitely gets into this stuff.
