A Longitudinal Study of an Untreated Sample of Predominantly Late Onset Characterological Dysthymia

McCullough, J. P.; Kasnetz, Matthew D.; Braith, J. A.; Carr, Karen F.; Cones, James H.; Fielo, Jeffrey; Martelli, M

doi:10.1097/00005053-198811000-00003

Cited by 39 publications

(24 citation statements)

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“…Interestingly, in a prospective study of dysthymic patients over a 9-month period, McCullough et al 189 identified several features that distinguished the remitters from the nonremitters. Specifically, the nonremitters tended to exhibit a stable depressive attributional style and tended to employ inappropriate coping strategies.…”

Section: Psychosocial Factors and Stressors In Major Depressive Disormentioning

confidence: 99%

Dysthymia: a review of pharmacological and behavioral factors

et al. 2000

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Although dysthymia, a chronic, low-grade form of depression, has a morbidity rate as high as that of major depression, and increases the risk for major depressive disorder, limited information is available concerning the etiology of this illness. In the present report we review literature concerning the biological and characterological features of dysthymia, the effectiveness of antidepressant treatments, the influence of stressors in the precipitation and maintenance of the disorder, and both quality of life and psychosocial correlates of the illness. We also provisionally suggest that dysthymia may stem from disturbances of neuroendocrine and neurotransmitter functioning (eg, corticotropin releasing hormone and arginine vasopressin within the hypothalamus, or alternatively monoamine variations within several extrahypothalamic sites), and may also involve cytokine activation. The central disturbances may reflect phenotypic variations of neuroendocrine processes or sensitization of such mechanisms. It is suggested that chronic stressor experiences or stressors encountered early in life lead to the phenotypic neurochemical alterations, which then favor the development of the dysthymic state. Owing to the persistence of the neurochemical disturbances, vulnerability to double depression is increased, and in this instance treatment with antidepressants may attenuate the symptoms of major depression but not those of the basal dysthymic state. Moreover, the residual features of depression following treatment may be indicative of underlying neurochemical disturbances, and may also serve to increase the probability of illness recurrence or relapse. Molecular Psychiatry (2000) 5, 242-261.

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Section: Psychosocial Factors and Stressors In Major Depressive Disormentioning

confidence: 99%

Dysthymia: a review of pharmacological and behavioral factors

et al. 2000

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“…Our paper cannot contribute to the two latter questions, which were dealt with for instance, by Klein et al (1988a) and McCullough et al (1988). For this reason, DSM-III-R suggests the dis-tinction of primary versus secondary dysthymia, early onset versus late onset cases, and dysthymia with and without an accompanying personality disorder.…”

Section: Discussionmentioning

confidence: 84%

The Zurich study

Angst

Wicki²

1991

Eur Arch Psychiatry Clin Nuerosci

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Dysthymia was assessed in the prospective Zurich Cohort Study of young adults. The 1-year prevalence rate was around 3% if no exclusion criteria were applied. Pure dysthymics without major or recurrent brief depression accounted for about 1%. Most cases of dysthymia met the symptom criteria for major depressive disorder (MDD) and were characterized by a more continuous course. However, evidence presented in this paper suggests that a diagnosis separate from MDD is not warranted. The family history of dysthymic subjects did not differ from major depressives. The smaller group of primary dysthymics, on the other hand, did not differ from controls as regards family history for treated depression. The low prevalence rates, taken together with methodological problems involved in assessing dysthymia and the lack of a distinct course, suggest that dysthymia does not constitute a valid subtype of depression in an age group of 20-30 years of the community. Dysthymia belongs to the wide spectrum of major depressive syndromes and represents only a subgroup characterized by specific course characteristics.

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“…16 Spontaneous fluctuations in the severity of obsessive-compulsive disorder 17,18 may be so large as to meet criteria for response. Remission with the passage of time has also been described in dysthymia 19 and generalized anxiety disorder. 20 Thus, with many psychiatric disorders, the longer the treatment duration (whether with active drug or placebo), the greater the chance that at least some patients will respond or remit as a function of the natural course of illness.…”

Section: Why Patients Improve With Treatment: Looking Beyond the Drugmentioning

confidence: 94%

There’s More to Placebo-Related Improvement Than the Placebo Effect Alone

Andrade

2012

J. Clin. Psychiatry

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A Longitudinal Study of an Untreated Sample of Predominantly Late Onset Characterological Dysthymia

Cited by 39 publications

References 0 publications

Dysthymia: a review of pharmacological and behavioral factors

Dysthymia: a review of pharmacological and behavioral factors

The Zurich study

There’s More to Placebo-Related Improvement Than the Placebo Effect Alone

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