$Unique_ID{BRK03687} $Pretitle{} $Title{Dysthymia} $Subject{Dysthymia Depressive Neurosis Depression Mild Major Depression} $Volume{} $Log{} Copyright (C) 1990 National Organization for Rare Disorders, Inc. 760: Dysthymia ** IMPORTANT ** It is possible that the main title of the article (Dysthymia) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Depressive Neurosis Depression, Mild Information on the following diseases can be found in the Related Disorders section of this report: Major Depression General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Dysthymia is a common psychological disorder characterized by a chronic but mild depressive state that has been present in an individual for more than two years. When the depressive state has lasted for several years, it may be difficult to distinguish between a person's usual functioning and the mood disturbance. Dysthymia is a chronic mood disturbance which is classified as a form of neurosis. It must be distinguished from Major Depression Disorders. Symptoms Dysthymia usually begins with an easily recognizable onset, and is followed by depression (or irritability in children or adolescents). During this period of depressed mood, there may be poor appetite or overeating, an inability to sleep (insomnia) or oversleeping (hypersomnia), low energy or fatigue, low self-esteem, poor concentration, difficulty making decisions and feelings of hopelessness. In order for an individual to be diagnosed as having Dysthymia, the depression must have lasted for a two-year period (one year in children), with periods of relief lasting no more than two months. The diagnosis of Dysthymia is made after an organic problem or prolonged use of medications (e.g., antihypertensives, recreational drugs, etc.), have been ruled out. Individuals with Dysthymia usually have some problems in social and occupational functioning due to the length of the depression rather than the severity. Hospitalization is rarely required unless there is a suicide attempt or an accompanying severe depression. There may also be problems with drug or alcohol abuse. In children and adolescents, relationships with peers and adults may be affected. Depressed children may react negatively or shyly to praise, and school performance may also be adversely affected. Causes Dysthymia may occur as a consequence of other mental disorders such as anorexia nervosa, the presence of physical symptoms with no physiological cause (somatization disorder), alcohol or drug dependence, anxiety disorder or chronic disabilities that cause a severe change in life style (i.e., rheumatoid arthritis, multiple sclerosis, etc.). In children and adolescents, predisposing factors may include a hyperactive disorder, a conduct disorder, mental retardation, a severe developmental disorder, or an inadequate, disorganized, rejecting and chaotic living environment. Dysthymia may also occur without a preexisting condition. (For more information, choose "Anorexia Nervosa" as your search term in the Rare Disease Database.) Affected Population Dysthymia occurs in both males and females. In adults, the disorder is more common in females than in males, while in children it appears to occur equally in both sexes. Dysthymia is more common in biological relatives of people with major depression than among the general population. Age of onset is most commonly under 21 years of age. Related Disorders Symptoms of the following disorders can be similar to those of Dysthymia. Comparisons may be useful for a differential diagnosis: Major Depression is a mood disorder characterized by severe depression with loss of interest or pleasure in all or nearly all activities for a period of at least two weeks. Symptoms may include appetite disturbance, change in weight, sleep disturbance, decreased energy, psychomotor agitation or retardation, feelings of worthlessness, excessive or inappropriate guilt, difficulty thinking or concentrating, recurrent thoughts of death and suicidal thoughts or attempts. This diagnosis is made only after it cannot be established that a physiological factor initiated and maintained the disturbance. Therapies: Standard Treatment of Dysthymia is psychological counseling with or without antidepressant drugs. In some patients heterocyclic drugs like desipramine followed by lithium carbonate may be helpful. Therapies: Investigational This disease entry is based upon medical information available through July 1990. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Dysthymia, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Manic/Depressive Association P.O. Box 753 Northbrook, IL 60062 (312) 446-9009 National Mental Health Association 1021 Prince St. Alexandria, VA 22314 National Alliance for the Mentally Ill 1901 N. Fort Meyer Dr., Suite 500 Arlington, VA 22209 (703) 524-7600 National Mental Health Consumer Self-Help Clearinghouse 311 S. Juniper St., Rm. 902 Philadelphia, PA 19107 (215) 735-2481 NIH/National Institute of Mental Health (NIMH) 9000 Rockville Pike Bethesda, MD 20205 (301) 443-4515 or (301) 496-1752 (800) 421-4211 (24 hrs.) References DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, 3d.: R.L. Spitzer, et al., eds; American Psychiatric Association, 1984. Pp. 230-233. THE MERCK MANUAL, Volume 1, 14th Ed.: Robert Berkow, M.D., ed.-in-chief; Merck Sharp & Dohme Laboratories, 1982. Pp. 1514, 1531. THE EPIDEMIOLOGY OF DYSTHYMIA IN FIVE COMMUNITIES: RATES, RISKS, COMORBIDITY, AND TREATMENT. M.M. Weissman et al.; AM J PSYCHIATRY (July, 1988; Issue 145(7)). Pp. 815-819. THE EARLY-LATE ONSET DISTINCTION IN DSM-III-R DYSTHYMIA. D.N. Klein et al.; J AFFECTIVE DISORD (January-February, 1988; issue 14(1)), Pp. 25-33.