A nurse on a mental health unit is caring for clients who have various depressive disorders. The nurse should identify which of the following client diagnoses as presenting the greatest risk for suicide?

A. Persistent depressive disorder: This disorder involves chronic, mild-to-moderate depressive symptoms lasting at least two years. While it can affect quality of life and increase risk for complications, the intensity of depressive symptoms is typically lower, so the immediate suicide risk is generally less than in major depressive disorder. B. Premenstrual dysphoric disorder: This condition involves mood changes and depressive symptoms in the luteal phase of the menstrual cycle. Symptoms are cyclical and usually resolve with the onset of menstruation, so the overall risk for suicide is lower compared with chronic or severe depressive disorders. C. Seasonal affective disorder: This disorder is characterized by depressive episodes occurring seasonally, usually in winter. While it can cause significant distress, it is typically predictable and temporary, making the acute suicide risk lower than in major depressive disorder. D. Major depressive disorder: Clients with major depressive disorder experience intense and persistent depressive symptoms, including hopelessness, guilt, and impaired functioning. These factors significantly increase the risk of suicidal ideation and attempts.