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Depression, Anxiety, and Apathy
Published in Marc E. Agronin, Alzheimer's Disease and Other Dementias, 2014
When the term depression is used within the context of dementia, it may refer to MDD or to the atypical or less severe forms of depression often included under the labels “minor depression,” “subsyndromal depression,” or “depressive disorder, not otherwise specified.” Other relevant syndromes involving depressive symptoms include dysthymic disorder, adjustment disorder, depressive personality disorder, bereavement, and bipolar disorder. To diagnose an individual with a major depressive episode according to criteria from either the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013), an individual must have a sad or depressed mood and/or a significant decrease in interest or pleasure in almost all activities, nearly every day for most of the day, for at least two weeks, as well as four or more of the following features: significant change in weight or appetite;insomnia or hypersomnia nearly every day;psychomotor agitation or retardation;fatigue or loss of energy nearly every day;feelings of worthlessness or excessive or inappropriate guilt;diminished ability to think or concentrate; orrecurrent thoughts of death or suicidal ideation or suicidal plan or attempt.
Incremental health care resource use and costs among adult patients with depression and treated for insomnia with zolpidem, trazodone, or benzodiazepines
Published in Current Medical Research and Opinion, 2022
Emerson M. Wickwire, Diana T. Amari, Timothy R. Juday, Feride Frech, Deval Gor, Manoj Malhotra
Patients with D + TI were required to have a diagnosis of depression and at least 1 prescription for an insomnia medication of interest during the study period; the earliest fill date for an insomnia medication from January 1, 2012 to September 30, 2017 (identification period) was identified as the “index date.” Eligible patients were required to be aged 18 years or older at the study index date, with at least 12 months of continuous health plan enrollment with full medical and drug coverage before the index date (i.e. “baseline” period). Patients were also required to have at least 12 months of continuous enrollment post-index date (i.e. “follow-up” period). Patients were required to have ≥1 ICD-9 or ICD-10 corresponding to depression during the baseline period or on the index date. Depression was defined as patients with MDD, bipolar I depression, dysthymic disorder/persistent depressive disorder, adjustment disorder, other cerebral degeneration, chronic depressive personality disorder, post-schizophrenic depression, recurrent depressive disorder and/or mixed anxiety and depressive disorder. Patients with missing information related to age and/or sex were excluded.
Clinical characteristics of poly-drug abuse among heroin dependents and association with other psychopathology in compulsory isolation treatment settings in China
Published in International Journal of Psychiatry in Clinical Practice, 2018
Mei Yang, Shu-Cai Huang, Yan-Hui Liao, Yi-Ming Deng, Hai-Yan Run, Ping-Liang Liu, Xiong-Wen Liu, Tie-Bang Liu, Shui-Yuan Xiao, Wei Hao
For the association of polydrug abuse and depressive personality disorder, comparisons to other studies are limited because lack of comparable studies. We noticed that there exists a long-standing debate on whether depressive personality disorder is conceptually distinct from the dysthymia diagnosis in axis-I disorder, since these two disorders are highly overlapped and both constructed with chronic, low-level and subthreshold depressions (Huprich, Porcerelli, Keaschuk, Binienda, & Engle, 2008; Rhebergen et al., 2012; Ryder, Schuller, & Bagby, 2006); Previous research had found a range of 18 to 95% overlap of depressive personality and dysthymic disorder. Despite debate exists, evidence had still shown distinctiveness in constructs between the two disorders (Huprich et al., 2008; Huprich, 2009; Markowitz et al., 2005; Ryder et al., 2006), and in this current study, the overlap level were relatively low (14.3% [9/63] of dysthymia among subjects with depressive personality disorder and 20.5% [9/44] of depressive personality disorder among subjects with dysthymia, respectively; unpublished results). Thus, we hold the opinion that depressive personality and dysthymic disorder are differentiated entities, although closely related, and depressive personality disorder to be independent predictors of polydrug abuse in this study is implicative for treatment. This study showed nominal associations of polydrug abuse and lifetime major depressive and dysthymic disorders in univariate while not multivariate analyses, suggesting an apparent relation of axis-I mood disorders to polydrug abuse that may root from depressive personality disorder.
From dysthymia to treatment-resistant depression: evolution of a psychopathological construct
Published in International Review of Psychiatry, 2020
Antonio Ventriglio, Dinesh Bhugra, Gaia Sampogna, Mario Luciano, Domenico De Berardis, Gabriele Sani, Andrea Fiorillo
In 1980, the DSM-III proposed the concept of chronic (and neurotic) depression with the new label of ‘Dysthymic Disorder’ (APA, 1980; Kocsis & Frances, 1987; Torgersen, 1986). Despite the atheoretical model inspiring the newer version of the diagnostic manual, the task force of DSM-III approved the removal of chronic depression from the domain of character and personality disorders: dysthymic disorder included both primary depressions with residual chronicity as well as character-based depressions (personality disorders) (APA, 1980; Kocsis & Frances, 1987; Torgersen, 1986). The DSM-III-R (APA, 1987) and the DSM-IV (APA, 1994) incorporated these definitions, and the Depressive Personality Disorder has been proposed in the research section of DSM-IV (APA, 1987; , 1994). In the Text Revision of DSM-IV (DSM-IV TR; APA, 2000), the Dysthymic Disorder diagnostic criteria included depressed mood for most of the day for more days for at least 2 years, and two of the following symptoms: (1) poor appetite or overeating; (2) insomnia or hypersomnia; (3) low energy or fatigue; (4) low self esteem; (5) poor concentration or difficulty making decisions; and (6) feelings of hopelessness. Also, during the first 2 years after the onset, episodes of major depression were excluded. In the Appendix B of the DSM-IV-TR (APA, 2000), the construct of depressive personality disorder, controversially overlapping with dysthymic disorder, included five or more of the following symptoms: (1) usual mood is dominated by dejection, gloominess, cheerlessness, joylessness and unhappiness; (2) self-concept centred on beliefs of inadequacy, worthlessness and low self-esteem; (3) the patient is critical, blaming and derogatory towards the self; (4) the patient is brooding and worried; (5) the patient is negativistic, critical and judgmental towards others; (6) the patient is pessimistic; (7) the patient is prone to feeling guilty or remorseful (Ryder et al., 2002).