Insomnia in Medicine / Internal Medicine — Case | Psychiatry | SMLE Q#1443
SMLE Question #1443
Medicine / Internal Medicine
Psychiatry
Last updated: February 2026
A 26-year-old primigravida presents 10 days after an uncomplicated vaginal delivery. For 2 weeks, she has become increasingly suspicious and socially withdrawn with insomnia and poor self-care. She reports seeing “snakes near the baby” and believes they will harm the infant despite reassurance. She refuses to be left alone with the baby and cannot reliably care for the infant. What is the most likely diagnosis?
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