QuestionSBA
QuestionChoice
The build-up of symptoms in the week before menstruation makes them more likely to be pre-menstrual in origin, rather than due to GAD. GAD sufferers tend to have persistent anxiety throughout the month that does not usually get better after menstruation has finished.
10025518
d
General anxiety disorder (GAD)
QuestionChoice
The build-up of symptoms in the week before menstruation makes them more likely to be pre-menstrual in origin, rather than due to depression. There is no pattern of monthly alleviation and deterioration in pure depressive disease.
10025517
c
Depression
QuestionChoice
An acute stress reaction develops in response to severe physical and/or mental stress, for example witnessing a fatal road traffic accident. It should last no more than one month. This patient does not make reference to a traumatic event, and her symptoms have been ongoing for more than one month. This, plus the variation in symptom severity according to menstruation, is more in keeping with pre-menstrual syndrome than an acute stress reaction.
10025519
e
Acute stress reaction
QuestionChoice
Any long-standing psychiatric symptoms such as mood swings should always be investigated and not dismissed as normal. In this case the women is likely  suffering from pre-menstrual syndrome, as her symptoms and fatigue seem to peak in the week before her period starts.
10025516
b
Normal physiology
QuestionChoice
Psychological symptoms and fatigue that seem to peak in the week before menstruation in a pre-menopausal women should raise suspicion of pre-menstrual syndrome. This typically occurs in a relapsing-remitting fashion over a number of months.
10025515
a
Pre-menstrual syndrome
Concept
Chapter
2693
5847
Pre-menstrual syndrome
Topic
176
Gynaecology
17501
A 26 year old woman has been suffering from severe mood swings, anxiety and fatigue for the past 6 months. She tells her GP that her symptoms significantly worsen in the week before her period starts, and then get somewhat better once her period has ended. She is otherwise fit and well with no regular medications.

Which of the following is the most likely diagnosis?
a