DYSTHYMIA DSM 5 MANUAL

The pathophysiology of dysthymia is not fully understood. Although dysthymia has long been considered to be less severe than major depression, the consequences of this condition are increasingly recognized as potentially grave, including severe functional impairment, increased morbidity from physical disease, and even an increased risk of suicide. Due to the stigma still associated with depression, many people with this disorder may be unrecognized and untreated. These varieties of depressed mood states, while distinct diagnostic entities, share similar symptoms and respond to similar pharmacologic and psychotherapeutic approaches. Major depressive disorder, dysthymia, double depression, and some apparently transient dysphorias may all be manifestations of the same disease process. It is often difficult to differentiate dysthymia from major depression specifically in patients with partial remission or partial response to treatment. In the past, dysthymia has had several other names, including depressive neurosis, neurotic depression, depressive personality disorder, and persistent anxiety depression.ДSM-IV-TR categorizes dysthymia according to several course specifiers: (1) early onset if symptoms begin before the age of 21 years, (2) late onset if symptoms begin at age 21 or later, and (3) dysthymia with atypical features if symptoms include increased appetite or weight gain, hypersomnia, a feeling of leaden paralysis, and extreme sensitivity to rejection.

DYSTHYMIA DSM 5 MANUAL

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) states that transient euthymic episodes lasting for up to two months may occur during the course of dysthymia. To diagnose dysthymia, major depressive episodes must not have occurred during the first two years of the illness (one year in children or adolescents), and there should be no history of mania. Dysthymia manifests as a depressed mood persisting for at least two years (one year for children or adolescents) that lasts for most of the day, occurs on more days than not, and is accompanied by at least two of the following symptoms: (1) poor appetite or overeating, (2) insomnia or hypersomnia, (3) low energy or fatigue, (4) low self-esteem, (5) poor concentration or difficulty making decisions, (6) feelings of hopelessness.

Although by definition, the depressed mood of dysthymia is not severe enough to meet the criteria for major depressive disorder, it is accompanied by significant subjective distress or impairment of social, occupational, or other important activities as a result of mood disturbance. DysthymiaДysthymia is a depressive mood disorder that is characterized by chronic, persistent but mild depression, affecting 3вЂ“6% of individuals in the community and as many as 36% of outpatients in mental health settings. Medication choice should be determined according to the background and underlying etiology of the targeting disease. Acetylcholine esterase inhibitors, methylphenidate, atypical antipsychotics, nicergoline, and cilostazol are another choice. Dopaminergic agonists seem to be effective for apathy. However, selective serotonin reuptake inhibitors (SSRIs) may be less effective for apathy in depressed elderly patients and have even been reported to worsen apathy. Antidepressants, especially noradrenergic agents, are useful for depression-related apathy. It is symptomatologically important that apathy is related to, but different from, major depression from the viewpoint of its causes and treatment. Apathy may also occur in various psychiatric and neurological disorders, including schizophrenia, stroke, Parkinson's disease, progressive supranuclear palsy, Huntington's disease, and dementias such as Alzheimer's disease, vascular dementia, and frontotemporal dementia. It is often difficult to be distinguished from major depression, specifically in its partially remitted state because вЂњloss of interestвЂќ or вЂњapathyвЂќ tends to prevail both in dysthymia, and remitted depression. Dysthymia is a depressive mood disorder characterized by chronic and persistent but mild depression.

Dysthymia dsm 5