Sleep Outside This Premenstrual in Medicine / Internal Medicine — 27yo Woman | Psychiatry | SMLE Q#12175

SMLE Question #12175

Medicine / Internal Medicine Psychiatry

Objective: OBJ-253

Last updated: February 2026
A 27-year-old woman has 8 months of marked irritability, insomnia, and recurrent suicidal thoughts that begin about 5 days before menses and resolve within 1–2 days after menstrual bleeding starts. She functions well the rest of the month and has no episodes of elevated mood, increased energy, or decreased need for sleep outside this premenstrual period. What is the most likely diagnosis?

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