Transcript Dysthymia - Roger Peele

Dysthymia
Unless otherwise indicated, answers
are from DSM-IV-TR, First & Tasman
or Tenth Ed of Sadock and Sadock.
As of 6Sep08.
Dysthymia - criteria
Q. Basic criteria for dysthymia?
Dysthymia - criteria
Ans. Key is “at least two years” of the
following:
a. Sad mood
b. Two or more of 1] under or overeating, 2]
over or under sleeping, 3] anergy; 4] low
self-esteem; 5] difficulty focusing; 6]
feeling hopeless.
c. Not part of another disorder, e.g., never
been manic.
Specifiers
Q. What is “late onset” as to dysthymia?
Specifiers
Ans. 21 years old separates “early” from
“late” onset.
Specifier
Q. Besides onsets, what other specifier
applies to dysthymia?
specifier
Ans.
Atypical, same criteria as MDD.
Lab findings
Q. What are lab findings in dysthymia?
Lab findings
Ans. ¼ to ½ have polysomnographic
abnormalities of:
- Decreased REM latency
- Increased REM density
- Reduced slow wave
Lab findings and meds
Q. Any treatment implications as to
polysomnographic features?
Lab findings and meds
Ans.
May respond better to meds than those
whose polysomnographic findings are
normal.
Prevalence
Q. Prevalence of dysthymia?
Prevalence
Ans.
Lifetime: 6%
Community surveys: 3% at any one time
Familial pattern
Q. If a pt has dysthymia, is there an
increased prevalence in first degree
relatives for dysthymia? For MDD?
Familial pattern
Ans. For both.
Treatment
Q. Best treatment response is achieved,
very generally, by?
Treatment
Ans. Use of both an antidepressant and
CBT.
Meds for Dysthymia
Q. Sadock & Sadock recommend which
meds?
Meds
Ans. SSRIs, venlafaxine, and bupropion.
Also, for those not responding consider
MAOIs or “judicious” use of
amphetamines.