Question

A 22-year-old patient with regular periods reports tension, depressed mood and decreased productivity towards the end of each cycle. She is otherwise healthy and maintains a high-profile job. Her past medical history is benign and she denies prior psychiatric problems. She denies smoking and drinks alcohol socially. What is the next best step in the management of this patient?

A. Reassure her that her monthly symptoms are normal
B. Initiate anti-depressant therapy
C. Psychiatry consult
D. Ascertain the timing of her symptoms each month
E. Initiate psychotherapy

Answer 1

The next best step in the management of this patient with tension, depressed mood, and decreased productivity towards the end of each cycle is to ascertain the timing of her symptoms each month.

Step-by-step explanation:

The next best step in the management of this patient would be D. Ascertain the timing of her symptoms each month. The patient is experiencing tension, depressed mood, and decreased productivity towards the end of each cycle, suggesting that her symptoms may be related to premenstrual dysphoric disorder (PMDD). Ascertain the timing of her symptoms each month will help confirm the diagnosis and guide further management.