A 60 - year - old man whose wife died 3 months back now stas to believe that his intestines have rotten away and that he is responsible for the death of his wife and should be sent to prison.How will you treat him?

The symptoms in this question are suggestive of nihilistic delusions (intestine are rotting away) and pathological guilt (belief that patient is responsible for death). Both these symptoms are usually seen in patients with severe depression. The death of wife could have acted as the stressor that resulted in the development of severe depressive episode with psychotic symptoms (or psychotic depression). Hence, this patient should be treated with antidepressants and antipsychotics.