Etiology of Cyclothymic Disorder

Etiology
Like with dysthymic disorder, exist controversy about whether cyclothymic disorder associated with mood disorders, either biological or psychological. Researchers have postulated that cyclothymic disorder have a close relationship with borderline personality disorder than a mood disorder. Despite these Controversies, the preponderance of biological and genetic data Favors the idea of cyclothymic disorder as a bonafide mood disorder.

Biological factors
Discovered exist Approximately 30 percent from all patients with cyclothymic disorder have a history of bipolar I disorder in their family, this figure is similar to the rate for patients with bipolar disorder I. In addition, a family pedigree with bipolar I disorder often contain generations of patients with bipolar I disorder are linked by a generation with cyclothymic disorder. In contrast, the prevalence of cyclothymic disorders in families of patients with bipolar I disorder is much higher than the prevalence of cyclothymic disorder both in families of patients with other mental disorders or in people who are mentally healthy. The observation that approximately one third of patients with cyclothymic disorder subsequently have major mood disorder, that they are very sensitive to antidepressant-induced hypomania, and that about 60 percent respond to lithium, add support to the idea of cyclothymic disorder as mild or attenuated form of bipolar II disorder.

Psychosocial factors
Most psychodynamic theories postulated to explain that development of cyclothymic disorder lies in the trauma and fixation during the oral stage of infant development. Freud hypothesized that the cyclothymic state is an attempt to overcome the ego and superego is harsh punishment. Psychodynamically hypomania described as a lack of self-criticism and the absence of obstacles that occur when someone throws the burden of depression is too harsh superego. The main defense mechanism is denial of hypomania, in which patients avoid the problem of external and internal feelings of depression.

Patients with cyclothymic disorder characterized by periods of depression alternating with periods of hypomania. Psychoanalytic exploration revealed that the patient is defending itself against the underlying themes of depression with their periods of euphoria or hypomanic. Hypomania is often triggered by the loss of interpersonal depth. False euphoria generated in such cases is the way the patient to reject dependence on the object of love and simultaneously deny any aggression or destruction that may have contributed to the loss of a loved one.

Diagnosis and Clinical Features
Although many patients looking for psychiatric help for their depression, their problems often associated with disorder in a manic episode that bothered them. Physicians should consider the diagnosis of cyclothymic disorder when the patient showed sociopathic behavior problems. Marital difficulties and instability in relationships is a common complaint, because patients with cyclothymic disorder often promiscuous and angry while in manic and mixed states. Despite exist anecdotal reports of increased productivity and creativity when hypomanic patients, most physicians reported that their patients become irregular and ineffective in work and school during this period.

DSM-IV-TR diagnostic criteria for cyclothymic disorder that the patient never stimulate meet the criteria for major depressive episode and do not meet the criteria for a manic episode during the first 2 years of disruption experienced by them. The criteria also require the presence of more or less constant symptoms for 2 years (or 1 year for children and adolescents).

Next: Variants of Dysthymic Disorders