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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: Sad mood

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Dysthymia

Unless otherwise indicated, answers are from DSM-IV-TR, First & Tasman or Tenth Ed of Sadock and Sadock.

As of 6Sep08.


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Dysthymia - criteria

Q. Basic criteria for dysthymia?


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Dysthymia - criteria

Ans. Key is “at least two years” of the following:

  • Sad mood

  • 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.

  • Not part of another disorder, e.g., never been manic.


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Specifiers

Q. What is “late onset” as to dysthymia?


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Specifiers

Ans. 21 years old separates “early” from “late” onset.


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Specifier

Q. Besides onsets, what other specifier applies to dysthymia?


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specifier

Ans.

Atypical, same criteria as MDD.


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Lab findings

Q. What are lab findings in dysthymia?


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Lab findings

Ans. ¼ to ½ have polysomnographic abnormalities of:

  • Decreased REM latency

  • Increased REM density

  • Reduced slow wave


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Lab findings and meds

Q. Any treatment implications as to polysomnographic features?


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Lab findings and meds

Ans.

May respond better to meds than those whose polysomnographic findings are normal.


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Prevalence

Q. Prevalence of dysthymia?


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Prevalence

Ans.

Lifetime: 6%

Community surveys: 3% at any one time


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Familial pattern

Q. If a pt has dysthymia, is there an increased prevalence in first degree relatives for dysthymia? For MDD?


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Familial pattern

Ans. For both.


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Treatment

Q. Best treatment response is achieved, very generally, by?


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Treatment

Ans. Use of both an antidepressant and CBT.


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Meds for Dysthymia

Q. Sadock & Sadock recommend which meds?


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Meds

Ans. SSRIs, venlafaxine, and bupropion. Also, for those not responding consider MAOIs or “judicious” use of amphetamines.