Suicidal behavior Quiz: Ace Your Exams

A 39-year-old woman is brought to the clinic by her father for evaluation of depressed mood and worrisome remarks. The father states the patient has been isolated in her apartment for the past month following a “rough break up” with her long-term partner. She stopped going to work abruptly and no longer gardens, which she previously used to enjoy. The patient has been sleeping for 14 hours per day and states that she still feels tired all the time. She states that when she watches television, the news anchor repeatedly says that the patient “should kill herself” and that she is “worthless.” She has no significant past medical history and no previous history of hallucinations or delusions. Vitals are within normal limits. Physical examination reveals a disheveled, guarded woman. The remainder of the physical examination is noncontributory. Which of the following is the most likely diagnosis?