The correct set of durations
The mhGAP Intervention Guide (mhGAP-IG) sets a minimum symptom duration for each condition so that normal, short-lived reactions to adversity are not labeled as disorders. The matching set is: depression 2 weeks, posttraumatic stress disorder 1 month after the event, and prolonged grief disorder 6 months. Remembering these three thresholds lets the nurse decide who needs treatment and who needs support and watchful waiting after a disaster.
What each threshold means
For depression, mhGAP-IG requires core symptoms, such as persistent depressed mood or markedly diminished interest or pleasure, for at least 2 weeks, along with difficulty in daily functioning. Posttraumatic stress disorder is considered when characteristic symptoms (re-experiencing, avoidance, and a heightened sense of current threat) with considerable difficulty in daily functioning persist for at least 1 month after the potentially traumatic event. Prolonged grief disorder is suspected when intense yearning or longing for the deceased, often with emotional pain and difficulty functioning, lasts at least 6 months after the loss.
| Condition | Minimum duration in mhGAP-IG | Core features |
|---|
| Depression | 2 weeks | Persistent low mood or loss of interest, with impaired functioning |
| Posttraumatic stress disorder | 1 month after the event | Re-experiencing, avoidance, heightened sense of threat, with considerable difficulty functioning |
| Prolonged grief disorder | 6 months after the loss | Intense longing for the deceased and difficulty functioning |
Why the other sets are wrong
Watch out! The wrong options mix in numbers from other contexts. One month is not the depression threshold; core symptoms for 2 weeks are enough. Three months is not the mhGAP-IG threshold for posttraumatic stress disorder, and twelve months is not its duration for prolonged grief disorder. Using longer thresholds would delay care for survivors who already meet criteria, while using shorter ones would label normal distress as disorder.
Applying the thresholds in an evacuation center
Six weeks after the typhoon, the PTSD and depression windows can already be met, but prolonged grief disorder cannot yet be diagnosed. In the early weeks after a disaster, most people show distress that improves with basic needs, safety, social support, and psychological first aid. The nurse screens, provides support and psychoeducation, and follows up those whose symptoms persist past the thresholds and impair functioning. People with significant symptoms below the threshold still receive support and are reassessed rather than dismissed.
Exam takeaway
Key point! mhGAP-IG durations: depression 2 weeks, PTSD 1 month, prolonged grief 6 months. Think of the sequence as two weeks, one month, six months, increasing with how long a normal reaction is expected to last.