Variants of Dysthymic Disorders

Dysthymic Disorders often occurs in patients with chronic physical disorders, especially in older adults. Dysthymic Disorders is clinically seen depressive disorder that lasts for 6 months or more, has also been described in neurological conditions. According to recent World Health Organization (WHO) conference, Dysthymic disorder can worsen the prognosis of the underlying neurological disease; therefore, patients need to act pharmacotherapy.

Studies conducted in children have revealed cases of dysthymic disorders episodes with remissions, exacerbations, and ending on the complications of major depression, 15 to 20 percent and even falling on the condition of hypomanic, manic, or mixed episodes postpuberty. People with dysthymic disorder in adults, clinically can be tricky when it developed into a major depression. But the conditions they rarely develop into spontaneous hypomania or mania. When treated with antidepressants, sometimes some of them may develop a brief hypomanic switches which usually disappear when the dose of antidepressants lowered. Learn also about Holistic Care for Dysthymia in Children and Adolescent

Differential diagnosis on dysthymia disorder
Differential diagnosis in dysthymic disorder is basically closer to major depressive disorder. Some substances and medical illness can affect depressive symptoms of chronic and persistent. And also there are two very important problems to be considered in the differential diagnosis of dysthymic disorder, namely minor depressive disorder and recurrent brief depressive disorder.

Minor Depressive Disorder
Minor depressive disorder is characterized by episodes of depression symptoms that more severe than those seen in major depressive disorder. The difference between dysthymic disorder and minor depressive disorder especially episodic nature of symptoms in the latter. Patients with minor depressive disorder had a euthymic mood, whereas patients with dysthymic disorder have almost no euthymic period.

Recurrent Brief Depressive Disorder
Recurrent brief depressive disorder characterized by brief periods (less than 2 weeks) during episodes of depression are present. Patients with Recurrent brief depressive disorder will meet diagnostic criteria for major depressive disorder if they lasted longer episodes. Patients with recurrent brief depressive disorder differ from patients with dysthymic disorder in two ways, namely to have impaired episodic and more severe depressive symptoms.

Double Depression
An estimated 40 percent of patients with major depressive disorder also met criteria for dysthymic disorder, a combination often referred to as double depression. The available data support the conclusion that patients with double depression have a worse prognosis than patients with major depressive disorder. Treatment of patients with double depression should be directed to both disorders, because the resolution of symptoms of major depressive episode still leaves patients with significant mood disorders.

Alcohol and Substance Abuse
Patients with dysthymic disorder generally meet diagnostic criteria for substance-related disorders. This comorbidity may logically; patients with dysthymic disorder tend to develop methods of coping for their depressive disorders that involving substance abuse. Therefore, they tend to use alcohol; stimulants such as cocaine, or marijuana, the choice may depend primarily on the social context of the patient. The presence of comorbid diagnosis of substance abuse presented a diagnostic dilemma for physicians; long-term use of many substances can produce a picture indistinguishable from the symptoms of dysthymic disorder.