Dysthymia in a cross-cultural perspective.

WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences, Drug and Substance Abuse, Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria.
Current opinion in psychiatry (Impact Factor: 3.55). 11/2010; 24(1):67-71. DOI: 10.1097/YCO.0b013e32834136a5
Source: PubMed

ABSTRACT Dysthymia is a relatively less-studied condition within the spectrum of depressive disorders. New and important information about its status has emerged in recent scientific literature. This review highlights some of the findings of that literature.
Even though studies addressing the cross-cultural validity of dysthymia are being awaited, results of studies using comparable ascertainment procedures suggest that the lifetime and 12-month estimates of the condition may be higher in high-income than in low and middle-income countries. However, the disorder is associated with elevated risks of suicidal outcomes and comparable levels of disability whereever it occurs. 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.
Dysthymia is a condition of considerable public health importance. Our current understanding suggests that it should receive more clinical and research attention. Specifically, the development of better treatment approaches, especially those that can be implemented in diverse populations, deserves research attention.

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    ABSTRACT: Dysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. According to DSM IV-TR, Dysthymia is classified into two subtypes: early-onset, when it begins before 21 years-old, and late onset Dysthymia, when it starts after this age. Before age 21, symptoms of conduct disorder, attention deficit disorder and hyperactivity with a few vegetative symptoms are usually present. It is important to distinguish it from other types of depression, as earlier as possible. This would allow providing these patients with the appropriate treatment to attenuate the impact of symptoms, such as poor awareness of self-mood, negative thinking, low self-esteem, and low energy for social and family activities, which progressively deteriorate their life quality. The etiology of Dysthymia is complex and multifactorial, given the various biological, psychological and social factors involved. Several hypotheses attempt to explain the etiology of Dysthymia, highlighting the genetic hypothesis, which also includes environmental factors, and an aminergic hypothesis suggesting a deficiency in serotonin, norepinephrine and dopamine in the central nervous system. From our point of view, dysthymia cannot be conceived as a simple mild depressive disorder. It is a distinct entity, characterized by a chronic depressive disorder which could persist throughout life, with important repercussions on the life quality of both patients and families.
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    ABSTRACT: Up-to-date epidemiological data on depressive disorders is needed to understand changes in population health and health care utilization. This study aims to assess the prevalence of major depressive disorder (MDD) and dysthymia in the Finnish population and possible changes during the past 11 years. In a nationally representative sample of Finns aged 30 and above (BRIF8901), depressive disorders were diagnosed with the Composite International Diagnostic Interview (M-CIDI) in 2000 and 2011. To account for nonresponse, two methods were compared: multiple imputation (MI) utilizing data from the hospital discharge register and from the interview in 2000 and statistical weighting. The MI-corrected 12-month prevalence of MDD was 7.4% (95% CI 5.7-9.0) and of dysthymia was 4.5% (95% CI 3.1-5.9), whereas the corresponding figures using weights were 5.4% (95% CI 4.7-6.1) for MDD and 2.0% (95% CI 1.6-2.4) for dysthymia. Women (OR 2.33, 95% CI 1.6-3.4) and unmarried people (OR 1.54, 95% CI 1.2-2.0) had a higher risk of depressive disorders. There was a significant increase in the prevalence of depressive disorders during the follow-up period from 7.3% in 2000 to 9.6% in 2011. Prevalences were two percentage points higher, on average, when using MI compared to weighting. Hospital treatments for depressive disorders and other mental disorders were strongly associated with nonparticipation. The CIDI response rate dropped from 75% in 2000 to 57% in 2011, but this was accounted for by MI and weighting. Depressive disorders are a growing public health concern in Finland. Non-participation of persons with severe mental disorders may bias the prevalence estimates of mental disorders in population-based studies. Copyright © 2014 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 11/2014; 173C:73-80. DOI:10.1016/j.jad.2014.10.015 · 3.71 Impact Factor
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