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Cyclothymia
0%
0/6
Major Depressive Disorder
Double Depression
Dysthymia
100%
6/6
Bipolar Disorder
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Dysthymia is a milder form of depression that lasts for at least two years in adults or one year in children or adolescents. For the diagnosis of dysthymia, patients must have at least two of the following: poor concentration or difficulty making decisions, hopelessness, poor appetite or overeating, insomnia or hypersomnia, fatigue, and low self-esteem for two years. During the two year period, patients must not be without symptoms for more than two months at a time and must not have symptoms that meet the threshold for major depressive disorder. In dysthymia there are no manic or hypomanic symptoms. As in major depressive disorder, it is important to rule out medical causes such as hypothyroidism and Cushing's. Treatment is similar to major depressive disorder and consists of selective serotonin reuptake inhibitors, other antidepressants, and psychotherapy. The U.S. Preventive Services Task Force recommends screening in adolescents and adults in clinical practices that have systems in place to ensure accurate diagnosis, effective treatment, and follow-up. It does not recommend for or against screening for depression in children seven to 11 years of age or screening for suicide risk in the general population. The Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used and validated screening tools. Gureje discusses dysthymia. Dysthymia commonly carries a worse prognosis than major depressive disorder and comparable or worse clinical outcome than other forms of chronic depression. Whereas there is some evidence that psychotherapy may be less effective than pharmacotherapy in the treatment of dysthymia, the best treatment approach is one that combines both forms of treatment. Incorrect Answers: Answer 1: In cyclothymia, patient's have alternating periods of hypomania and mild to moderate depressive symptoms. Answer 2: The patient does not report enough depressive symptoms to qualify for major depressive disorder. Answer 3: In double depression, patients have major depressive disorder with dysthymic disorder during the residual periods. Answer 5: The patient does not report manic symptoms and thus does not qualify for bipolar disorder.
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