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Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
The prevalence rate of depression is 2% in children (5 to 8% in adolescents). Two different types of depression are generally distinguished: major depressive episode and dysthymic disorder. A major depressive episode is defined by the presence of specific signs of depression (depressed mood, loss of pleasure, sleep disorders, change in appetite, etc.) over a period of at least two weeks. A dysthymic disorder is a chronic mood disorder, characterised by mild to moderate symptoms of depression. A double depression is characterised by the joint presence of both disorders. Findings from the pharmacotherapy of depression in children are far from complete and concern almost exclusively major depressive episodes [12,13].
Psychosocial Assessment of GI Symptoms
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Stuart J. Eisendrath, Rafael O. Gray
Comorbid Dysthymia (“double depression”) or a personality disorder should always be considered in evaluating depression. The influence of longstanding characterological factors and coping styles has been increasingly investigated (20). Episodic vomiting as a manifestation of self-mutilation has been reported as a presenting symptom for patients with Borderline Personality Disorder (21). The treatment course can be complicated and may require adjunctive behavioral or psychotherapy approaches.
Case 11: I don’t want pills, I want someone to talk to
Published in Barry Wright, Subodh Dave, Nisha Dogra, 100 Cases in Psychiatry, 2017
Barry Wright, Subodh Dave, Nisha Dogra
This woman is presenting with low mood, tiredness, ideas of hopelessness, guilt and worthlessness with sleep disturbance of more than 2 years’ duration. This is superimposed on long-standing traits of pessimism and low self-esteem. She may be suffering from a moderate depressive episode although underlying dysthymia characterized by at least 2 years of low-grade depressive mood also needs to be considered. Depressive episode superimposed on dysthymia is called double depression. National Institute for Health and Care Excellence (NICE) guidance recommends CBT for depression. However, the guidelines do state that ‘psychodynamic psychotherapy may be considered for the treatment of the complex co-morbidities that may be present along with depression’.
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
Double depression is a common comorbidity referring to the co-existence of persistent depressive disorder (as defined in the DSM-5, which includes the old concept of dysthymia) and major depressive disorder (Keller & Shapiro, 1982). Research and clinical reports confirm that double depression cannot be considered as a distinct disorder, even if it shows a more severe outcome than either major depression or persistent depressive disorder alone, with a higher number of relapses and a poor response to pharmacological treatments (Dixon & Thyer, 1998; Keller & Shapiro, 1982; Parker & Malhi, 2019). The prevalence of double depression ranges from 2.2% to 26% (Goldney & Fisher, 2004; Keller & Shapiro, 1982). As already discussed, dysthymia and double depression both show poorer social- and functioning- recovery rates than major depression alone; comorbid somatic disorders and neuroticism have been identified as associated factors for a poorer social and psycho-physical functioning (Rhebergen et al., 2010).
Characterological depression in patients with narcissistic personality disorder
Published in Nordic Journal of Psychiatry, 2019
Jane Fjermestad-Noll, Elsa Ronningstam, Bo Bach, Bent Rosenbaum, Erik Simonsen
Kernberg et al. [16], also stress the point that even if there seems to be these distinctly different clinical patterns of symptoms, patients with PD, can nevertheless develop persistent depressive symptoms alike those of MD, and in this case the patient is considered to suffer from a so-called “double depression”. Mizushima et al. [3], performed a case rating investigation, using the Newcastle Diagnostic Depression Scale (NDDS), among 502 Japanese psychiatrists. They found a significant distinction between depression with melancholic versus reactive features. Ley et al. [17], investigated phenomenological differences between acute and chronic forms of depression, and found that chronic forms of depression were related interpersonal problems and dysfunctional beliefs, but the severity of depression and the occurrence of ruminations were equal in the two groups. They found that the patients with chronic forms of depression had a higher occurrence of early traumatic life-experiences.
Cytokine level in patients with mood disorder, alcohol use disorder and their comorbidity
Published in The World Journal of Biological Psychiatry, 2023
Irina A. Mednova, Lyudmila A. Levchuk, Anastasiia S. Boiko, Olga V. Roschina, German G. Simutkin, Nikolay A. Bokhan, Anton J. M. Loonen, Svetlana A. Ivanova
There were significantly more women in the MD group than in the groups AUD and MD + AUD. These differences are consistent with literature data. Adult women are about twice as likely to be diagnosed with major depression as men (Kessler 2003) and the gender difference continues in subjects of 60 year and older (Girgus et al. 2017). In this meta-analysis of Girgus et al. (2017), a small but significant difference in symptomatology between male and female depressed patients became evident. Men with depression were more likely to report alcohol/drug abuse and risk taking/poor impulse control, while depressed women reported more intensely depressed mood, appetite disturbance/weight change, and sleep disorders (Cavanagh et al. 2017). The large number of men in the group comorbidity MD + AUD is explained by the fact that patients were predominantly recruited from the department of addictive disorders. Relevant gender differences were also observed in a longitudinal study of 12–21 year old scholars (Marmorstein 2009). The largest association has been found between alcohol use and symptoms of depression in adolescent girls, but gender inequality decreases with age and levels off in adulthood. Evidence suggests that AUD increases the risk of MD, rather than vice versa which is probably attributable to pharmacological and metabolic changes as a result of long-term alcohol exposure (Boden and Fergusson 2011). In our study, dysthymia was the most common MD associated with AUD. However, among individuals of an European population with AUD, nearly 33% met the criteria for major depressive disorder, and only 11% - dysthymia (Grant et al. 2004; McHugh and Weiss 2019). However, in the aforementioned study, meeting during the preceding 12 months the criteria of the fourth edition of the diagnostic and statistical manual of mental disorders (DSM-IV) (American Psychiatric Association 1994) is applied much more strictly, resulting in a much lower prevalence of dysthymia than in our case. In addition, the ICD-10 diagnostic criteria for dysthymia may allow including probable cases of "double depression”, when dysthymia was in fact a manifestation of "underrecovery" from a previous depressive episode.