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07-SEPTEMBER-2008 03:17:44 - Dysthymia Please wikify this article or section. Help improve this article by adding relevant internal links. July 2008 Dysthymia Classification and external resources ICD-10 F34.1 ICD-9 300.4 Dysthymia pronounced /dɪsˈθaɪmiÉ™/ is a mood disorder that falls within the depression spectrum. It is considered a chronic depression, but with less severity than a major depression. This disorder tends to be a chronic, long-lasting illness.1 Contents 1 Duration 2 Symptoms 3 Diagnostic criteria 4 Treatment 4.1 Most effective treatments 5 See also 6 References Duration Dysthymia can start early in life, even in childhood, and it is constant. Treatment can reduce how long it lasts and the intensity of the symptoms.citation needed Symptoms The symptoms of dysthymia are similar to those of major depression, though they tend to be less intense. In both conditions, a person can have a low or irritable mood, lack of interest in things most people find enjoyable, and a loss of energy. Appetite and weight can be increased or decreased. The person may sleep too much or have trouble sleeping. He or she may have difficulty concentrating. The person may be indecisive and pessimistic and have a poor self-image. The symptoms can grow into a full blown episode of major depression. This situation is sometimes called double depression2 because the intense episode exists with the usual feelings of low mood. People with dysthymia have a greater-than-average chance of developing major depression. While major depression often occurs in episodes, dysthymia is more constant, lasting for long periods, sometimes beginning in childhood, as a result a person with dysthymia tends to believe that depression is a part of his or her character. The person with dysthymia may not even think to talk about this depression with doctors, family members or friends. Dysthymia, like major depression, tends to run in families. It is two to three times more common in women than in men. Others describe being under chronic stress. It is often difficult to tell whether people with dysthymia are under more stress than other people or if the dysthymia causes them to perceive more stress than others. Diagnostic criteria The Diagnostic and Statistical Manual of Mental Disorders3 DSM, published by the American Psychiatric Association, characterizes Dysthymic disorder. The essential symptom involves the individual feeling depressed almost daily for at least two years, but without the criteria necessary for a major depression. Low energy, disturbances in sleep or in appetite, and low self-esteem typically contribute to the clinical picture as well. Sufferers have often experienced dysthymia for many years before it is diagnosed. People around them come to believe that the sufferer is 'just a moody person.' Note the following diagnostic criteria:1 During a majority of days for 2 years or more, the patient reports depressed mood or appears depressed to others for most of the day. When depressed, the patient has 2 or more of: Appetite decreased or increased Sleep decreased or increased Fatigue or low energy Poor self-image Reduced concentration or indecisiveness Feels hopeless or pessimistic During this 2 year period, the above symptoms are never absent longer than 2 consecutive months. During the first 2 years of this syndrome, the patient has not had a Major Depressive Episode. The patient has had no Manic, Hypomanic or Mixed Episodes. The patient has never fulfilled criteria for Cyclothymic Disorder. The disorder does not exist solely in the context of a chronic psychosis such as Schizophrenia or Delusional Disorder. The symptoms are not directly caused by a general medical condition or the use of substances, including prescription medications. These symptoms must result in clinically significant distress or impairment in social, occupational, academic, or other major areas of functioning APA, 2000. Treatment As with other forms of depression, a number of treatments exist for Dysthymia. Doctors most commonly use psychotherapy, including cognitive-behavioral therapy, to help change the mind-set of the individual affected. Additionally doctors may prescribe a variety of antidepressant medications Most effective treatments Some evidence suggests the combination of medication and psychotherapy may result in the greatest improvement. The most commonly prescribed anti-depressants for this disorder are the selective serotonin reuptake inhibitors SSRIs,which include fluoxetine Prozac, sertraline Zoloft, paroxetine Paxil, and citalopram Celexa.citation needed. SSRIs are easy to take and relatively safe compared with older forms of anti-depressants.4. Other new anti-depressants include bupropion Wellbutrin, venlafaxine Effexor, mirtazapine Remeron, and duloxetine Cymbalta. There may be side effects of medication. SSRIs can cause nausea and problems with sexual functioning.citation needed They can cause anxiety to increase in the early stages of treatment and lead to apathy in the long run. Concerns about the increased risk of suicide have led the U.S Food and drug administration to advise many anti-depressant manufacturers to put prominent warning labels on their productscitation needed. The scientific community has not found that anti-depressants increase suicide risk, but a small number of people using the medications feel strikingly worse rather than better when they take them. It usually takes two to six weeks of anti-depressant use to see improvement. The dose may have to be adjusted. Often it will take up to a few months for the full positive effect to be seen. Sometimes two different anti-depressant medications are prescribed together, or your doctor may combine a mood stabilizer or anti-anxiety medication with an anti-depressant. The type of psychotherapy that will help depends on a number of factors, including the nature of any stressful events, the availability of family and other social support, and personal preference. Therapy should include education about depression. Support is essential. Cognitive behavioral therapy is designed to examine and help correct faulty, self-critical thought patterns and correct the cognitive distortions that persons with mood disorders commonly experience. Psychodynamic, insight-oriented or interpersonal psychotherapy can help a person sort out conflicts in important relationships or explore the history behind the symptoms. See also Anhedonia, a similar disorder characterized by a decreased or absent ability to enjoy a sense of pleasure. This may also be a symptom of schizophrenia and/or clinical depression. In addition, this disorder can be caused by excessive use of amphetamines. Blunted affect, a symptom of PTSD, schizophrenia, and ASPD involving decreased or absent emotional response Atypical depression Clinical depression References ^ a b Hersen, M., Turner, S. M., Beidel, D. C. Eds.. 2007. Adult Psychopathology and Diagnosis 5th ed.. Hoboken, New Jersey: John Wiley Sons, Inc. ^ Double Depression: Hopelessness Key Component Of Mood Disorder retrieved July 17, 2008 ^ June 2000 in American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, Fourth ion Text Revision, American Psychiatric Publishing, Inc., 943 pages. ISBN 978-0890420249. ^ National Institute of Mental Health What are the different forms of depression? 2008. In National Institute of Mental Health. Retrieved 2008-02-26 from http://www.nihm.nih.gov Diagnosis. 2008. In Encyclopedia Britannica. Retrieved 2008-02-26, from Encyclopedia Britannica Online: http://www.britannica.com/eb/article-24621 Dysthymia. 2008. Retrieved 2008-02-27, from http://www.intelhealth.com Gray, Peter. Psychology. New York: Worth Publishers, 2007 The Facts. 2008. In U.S Department of Health and Human Services. Retrieved 2008-02-26; from SAMSHA http://www.allmentalhealth.samsha.gov v d e WHO ICD-10 mental and behavioral disorders F · 290-319 Neurological/symptomatic Dementia Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia, Elopement, Sundowning, Wandering · Delirium · Post-concussion syndrome · Organic brain syndrome Psychoactive substance alcohol drunkenness, alcohol dependence, alcoholic hallucinosis, Alcohol withdrawal, delirium tremens, Korsakoff's syndrome, alcohol abuse · opioids opioid dependency · sedative/hypnotic benzodiazepine withdrawal · cocaine cocaine dependence · general Intoxication, Drug abuse, Physical dependence, Withdrawal Psychotic disorder Schizophrenia disorganized schizophrenia · Schizophreniform disorder · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder Mood affective Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia Neurotic, stress-related and somatoform Anxiety disorder Agoraphobia, Panic disorder, Panic attack, Generalized anxiety disorder, Social anxiety, Social phobia · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder Ganser syndrome · Somatoform disorder Somatization disorder, Body dysmorphic disorder, Hypochondriasis, Nosophobia, Da Costa's syndrome, Psychalgia · Neurasthenia Physiological/physical behavioral Eating disorder: Anorexia nervosa · Bulimia nervosa Sleep disorder: Dyssomnia Hypersomnia, Insomnia · Parasomnia REM behavior disorder, Night terror · Nightmare Sexual dysfunction: Erectile dysfunction · Premature ejaculation · Vaginismus · Dyspareunia · Hypersexuality · Female sexual arousal disorder Postpartum depression · Postnatal psychosis Adult personality and behavior Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation · Fetishism Mental retardation Mental retardation Psychological development developmental disorder Specific: speech and language expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp · Scholastic skills dyslexia, dysgraphia, Gerstmann syndrome · Motor function developmental dyspraxia Pervasive: Autism · Rett syndrome · Asperger syndrome Behavioral and emotional, childhood and adolescence onset ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech stuttering · cluttering Retrieved from http://en..org/wiki/Dysthymia Categories: Mood disordersHidden categories: All pages needing to be wikified | Wikify from July 2008 | All articles with statements | Articles with statements since July 2007 | Articles with statements since April 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية ÄŒesky Deutsch Ελληνικά Español Français Italiano עברית Nederlands Polski Português РуÑ?Ñ?кий Suomi Svenska This page was last modified on 22 August 2008, at 23:03
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