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Psych CASC / OSCEGeneral adult psychiatry — mood disorders / women's mental health

Psych CASC / OSCE · General adult psychiatry — mood disorders / women's mental health

Explain PMDD, diary confirmation and intermittent SSRI options — CASC communication station

MRCPsych/FRANZCP-style communication station: explain PMDD, prospective diary, continuous vs luteal SSRI dosing with a named regimen, suicide safety-netting, and when COC or specialist escalation is considered.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 27-year-old woman with severe premenstrual irritability and tearfulness wants a clear explanation of PMDD versus 'ordinary PMS', why she needs two months of daily symptom ratings, whether she can take an SSRI only before her period, and how to stay safe when passive death wishes return each luteal week.

Station brief

Format. Communication station, approximately 7–10 minutes after reading. You are the psychiatry registrar in outpatient clinic. [4]

Candidate instructions. Explain PMDD in plain language, justify two-cycle prospective ratings, offer an SSRI plan with continuous or luteal-phase options using a named drug and dose, address passive death wishes with a safety plan, check understanding, and outline when to seek urgent help. The examiner plays the patient. [1][4]

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References4ShowHide
  1. [1]Epperson CN, Steiner M, Hartlage SA, et al. Premenstrual dysphoric disorder: evidence for a new category for DSM-5 Am J Psychiatry, 2012.PMID 22764360
  2. [2]Steiner M, Steinberg S, Stewart D, et al. Fluoxetine in the treatment of premenstrual dysphoria. Canadian Fluoxetine/Premenstrual Dysphoria Collaborative Study Group N Engl J Med, 1995.PMID 7739706
  3. [3]Jespersen C, Lauritsen MP, Frokjaer VG, Schroll JB Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder Cochrane Database Syst Rev, 2024.PMID 39140320
  4. [4]Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders Aust N Z J Psychiatry, 2021.PMID 33353391
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