Passive Suicidal Thoughts That in Medicine / Internal Medicine — 27yo Woman | Psychiatry | SMLE Q#17523
SMLE Question #17523
Medicine / Internal Medicine
Psychiatry
Objective: OBJ-PSY-PRM-001
Last updated: February 2026
A 27-year-old woman presents to a family medicine clinic for recurrent mood symptoms. For 8 months, she develops marked irritability, insomnia, and depressed mood with passive suicidal thoughts that start about 5 days before menses and resolve within 1–2 days after bleeding begins. She feels well for the rest of each cycle. She has dysmenorrhea during menses. She denies substance use and has no history of manic or hypomanic episodes. Mental status examination today is normal, and she denies current suicidal intent or plan. What is the most likely diagnosis?
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