The Experts below are selected from a list of 3822 Experts worldwide ranked by ideXlab platform

Daniel N. Klein - One of the best experts on this subject based on the ideXlab platform.

  • Dysthymic Disorder and double depression prediction of 10 year course trajectories and outcomes
    Journal of Psychiatric Research, 2008
    Co-Authors: Daniel N. Klein, Stewart A. Shankman, Suzanne Rose
    Abstract:

    We sought to identify baseline predictors of 10-year course trajectories and outcomes in patients with Dysthymic Disorder and double depression. Eighty-seven outpatients with early-onset (<21 years) Dysthymic Disorder, with or without superimposed major depression, were assessed five times at 30-month intervals for 10 years. Baseline evaluations included semi-structured diagnostic interviews for Axis I and II psychopathology and childhood adversity. Direct interview and family history data were collected on first-degree relatives. Follow-up assessments included the Longitudinal Follow-up Evaluation and Hamilton Depression Rating Scale. Using mixed effects growth curve models, univariate predictors of depression severity and functional impairment at 10-year outcome included older age, less education, concurrent anxiety Disorder, greater familial loading for chronic depression, a history of a poorer maternal relationship in childhood, and a history of childhood sexual abuse. In addition, longer duration of Dysthymic Disorder also predicted greater impairment 10 years later. Predictors of a poorer trajectory of depressive symptoms over time included ethnicity and personality Disorders; predictors of a poorer trajectory of social functioning included familial loading of chronic depression and quality of the childhood maternal relationship. Thus, demographic, clinical, family history, and early adversity variables all contribute to predicting the long-term trajectory and outcome of DD. These variables should be routinely assessed in clinical evaluations and can provide clinicians with valuable prognostic information.

  • Dysthymic Disorder and double depression: prediction of 10-year course trajectories and outcomes
    Journal of psychiatric research, 2007
    Co-Authors: Daniel N. Klein, Stewart A. Shankman, Suzanne Rose
    Abstract:

    We sought to identify baseline predictors of 10-year course trajectories and outcomes in patients with Dysthymic Disorder and double depression. Eighty-seven outpatients with early-onset (

  • Ten-year prospective follow-up study of the naturalistic course of Dysthymic Disorder and double depression.
    The American journal of psychiatry, 2006
    Co-Authors: Daniel N. Klein, Stewart A. Shankman, Suzanne Rose
    Abstract:

    Objective: The purpose of this study was to describe the 10-year course and outcome of Dysthymic Disorder. Method: The authors conducted a naturalistic, prospective, longitudinal follow-up of 97 adults with early-onset Dysthymic Disorder and 45 adults with nonchronic major depressive Disorder selected from consecutive admissions to several outpatient facilities. Follow-up data were obtained for 90% of the cohort. Assessments were conducted at baseline, 30, 60, 90, and 120 months. Measures included the Longitudinal Interval Follow-Up Evaluation and the Hamilton Depression Rating Scale. Results: The Kaplan-Meier estimated recovery rate from Dysthymic Disorder was 73.9%, with a median time to recovery of 52 months. Among patients who recovered, the estimated risk of relapse into another period of chronic depression was 71.4%. Chronic depressive relapses took a variety of forms and were not limited to dysthymia. Nonetheless, the distinction between chronic and nonchronic forms of depression was relatively sta...

  • Mental health service use by patients with Dysthymic Disorder: treatment use and dropout in a 7 1/2-year naturalistic follow-up study.
    Comprehensive psychiatry, 2005
    Co-Authors: Brian R. Mcfarland, Daniel N. Klein
    Abstract:

    Little is known about long-term treatment use among patients with dysthymia. This paper describes patterns of treatment use by 85 outpatients with Dysthymic Disorder and a comparison group of 36 outpatients with nonchronic (episodic) major depression in a naturalistic follow-up. Patients with dysthymia had higher rates of treatment use across 7 1/2 years compared with patients with episodic major depression. Baseline variables that predicted which patients with dysthymia dropped out of treatment before recovering from Dysthymic Disorder included age, ethnicity, Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Axis II pathology as obtained from informant reports, higher self-reported autonomy, and receiving psychotherapy alone as compared to receiving a combination of psychotherapy and medication. Dysthymic Disorder places a significant burden on the mental health services system, yet many outpatients with dysthymia may be receiving inadequate treatment. Younger patients, ethnic minority patients, and patients with personality Disorders may be at increased risk of dropping out from treatment for depression. Combination treatments may increase treatment retention.

  • A growth curve analysis of the course of Dysthymic Disorder: the effects of chronic stress and moderation by adverse parent-child relationships and family history.
    Journal of consulting and clinical psychology, 2004
    Co-Authors: Lea R. Dougherty, Daniel N. Klein, Joanne Davila
    Abstract:

    Using mixed effects models, the authors examined the effects of chronic stress, adverse parent-child relationships, and family history on the 7.5-year course of Dysthymic Disorder. Participants included 97 outpatients with early-onset dysthymia who were assessed with semistructured interviews at baseline and 3 additional times at 30-month intervals for 7.5 years. Results indicated that higher levels of chronic stress 6 months prior to each follow-up predicted greater depression severity at follow-up, controlling for depression severity at the start of the chronic stress assessment. In addition, adverse parent-child relationships and family history of Dysthymic Disorder moderated this association. For patients with poorer parent-child relationships, chronic stress was associated with increased depression severity at follow-up, whereas patients with a higher familial loading for Dysthymic Disorder were less responsive to chronic stress over time.

D L Dunner - One of the best experts on this subject based on the ideXlab platform.

  • Current therapeutic approaches for Dysthymic Disorder
    Expert review of neurotherapeutics, 2003
    Co-Authors: D L Dunner
    Abstract:

    The purpose of this article is to review the literature regarding current treatments for Dysthymic Disorder. We will first discuss definitions of Dysthymic Disorder, demographics of these patients, clinical course and family history. We will then review treatment studies for psychotherapy, pharmacotherapy and combined treatment, discuss treatment guidelines for Dysthymic Disorder, render an ‘expert opinion’ regarding problems in the definition of Dysthymic Disorder, elaborate on areas for future research and speculate on a ‘five-year view.’

  • Dysthymic Disorder: treatment with citalopram.
    Depression and anxiety, 2002
    Co-Authors: D L Dunner, Helen E. Hendricksen, B S Carolyn Bea, B B A Chris Budech, Seth D. Friedman
    Abstract:

    We studied 15 patients with Dysthymic Disorder with open-label citalopram. The purpose of this study was to determine the dose range and safety of citalopram necessary for treatment of patients with Dysthymic Disorder and to attempt to increase doses in order to enhance remission of patients with Dysthymic Disorder when treated. Citalopram was well tolerated. The mean dose used in this 10-week study was 37.3 mg and the majority of patients responded to treatment. Various criteria for response and remission were employed. These findings are intended to give guidelines for a subsequent treatment study of Dysthymic patients with citalopram using a double-blind placebo-controlled strategy. Depression and Anxiety 15:18–22, 2002. © 2002 Wiley-Liss, Inc.

  • Dysthymic Disorder: treatment with mirtazapine.
    Depression and anxiety, 1999
    Co-Authors: D L Dunner, Helen E. Hendrickson, Carolyn Bea, Chris B. Budech, Elsa O'connor
    Abstract:

    Dysthymic Disorder is a form of chronic depression which often has its onset in childhood or adolescence and is generally persistent throughout life. Although originally hypothesized to be preferentially treated with psychotherapy, recent pharmacological studies support the use of antidepressants to treat patients with Dysthymic Disorder. Mirtazapine is an antidepressant which has been recently released on the U.S. market. We studied the effects of 15 to 45 mg of mirtazapine in 15 patients with Dysthymic Disorder on an open label basis over a 10-week period. Four patients discontinued treatment because of sedation. Mirtazapine was effective and well tolerated in the remaining patients. Depression and Anxiety 10:68–72, 1999. © 1999 Wiley-Liss, Inc.

  • Duration of periods of euthymia in patients with Dysthymic Disorder.
    The American journal of psychiatry, 1999
    Co-Authors: D L Dunner
    Abstract:

    OBJECTIVE: The purpose of this study was to assess the duration of periods of euthymia in patients with dysthymia. METHOD: All patients with dysthymia who came to the Center for Anxiety and Depression over a 10-month period (N=22) were interviewed by the author regarding the duration of their euthymic episodes. RESULTS: The 22 patients with dysthymia reported euthymic periods from 2 to 30 days (mean=8.0 days, SD=6.6). CONCLUSIONS: The euthymic period of up to 2 months that is specified in DSM-IV for Dysthymic Disorder might confound the results of clinical trials. Data from additional groups of Dysthymic patients would be useful when considering this issue for DSM-V.

  • Treatment of Dysthymic Disorder.
    Depression and anxiety, 1998
    Co-Authors: D L Dunner
    Abstract:

    Recent studies support the use of pharmacotherapy in the treatment of Dysthymic Disorder. This article reviews the relationship of the definition of Dysthymic Disorder to clinical treatment studies and discusses the treatment of Dysthymic Disorder with pharmacotherapy (with special emphasis on the use of fluoxetine) and psychotherapy.

Suzanne Rose - One of the best experts on this subject based on the ideXlab platform.

  • Dysthymic Disorder and double depression prediction of 10 year course trajectories and outcomes
    Journal of Psychiatric Research, 2008
    Co-Authors: Daniel N. Klein, Stewart A. Shankman, Suzanne Rose
    Abstract:

    We sought to identify baseline predictors of 10-year course trajectories and outcomes in patients with Dysthymic Disorder and double depression. Eighty-seven outpatients with early-onset (<21 years) Dysthymic Disorder, with or without superimposed major depression, were assessed five times at 30-month intervals for 10 years. Baseline evaluations included semi-structured diagnostic interviews for Axis I and II psychopathology and childhood adversity. Direct interview and family history data were collected on first-degree relatives. Follow-up assessments included the Longitudinal Follow-up Evaluation and Hamilton Depression Rating Scale. Using mixed effects growth curve models, univariate predictors of depression severity and functional impairment at 10-year outcome included older age, less education, concurrent anxiety Disorder, greater familial loading for chronic depression, a history of a poorer maternal relationship in childhood, and a history of childhood sexual abuse. In addition, longer duration of Dysthymic Disorder also predicted greater impairment 10 years later. Predictors of a poorer trajectory of depressive symptoms over time included ethnicity and personality Disorders; predictors of a poorer trajectory of social functioning included familial loading of chronic depression and quality of the childhood maternal relationship. Thus, demographic, clinical, family history, and early adversity variables all contribute to predicting the long-term trajectory and outcome of DD. These variables should be routinely assessed in clinical evaluations and can provide clinicians with valuable prognostic information.

  • Dysthymic Disorder and double depression: prediction of 10-year course trajectories and outcomes
    Journal of psychiatric research, 2007
    Co-Authors: Daniel N. Klein, Stewart A. Shankman, Suzanne Rose
    Abstract:

    We sought to identify baseline predictors of 10-year course trajectories and outcomes in patients with Dysthymic Disorder and double depression. Eighty-seven outpatients with early-onset (

  • Ten-year prospective follow-up study of the naturalistic course of Dysthymic Disorder and double depression.
    The American journal of psychiatry, 2006
    Co-Authors: Daniel N. Klein, Stewart A. Shankman, Suzanne Rose
    Abstract:

    Objective: The purpose of this study was to describe the 10-year course and outcome of Dysthymic Disorder. Method: The authors conducted a naturalistic, prospective, longitudinal follow-up of 97 adults with early-onset Dysthymic Disorder and 45 adults with nonchronic major depressive Disorder selected from consecutive admissions to several outpatient facilities. Follow-up data were obtained for 90% of the cohort. Assessments were conducted at baseline, 30, 60, 90, and 120 months. Measures included the Longitudinal Interval Follow-Up Evaluation and the Hamilton Depression Rating Scale. Results: The Kaplan-Meier estimated recovery rate from Dysthymic Disorder was 73.9%, with a median time to recovery of 52 months. Among patients who recovered, the estimated risk of relapse into another period of chronic depression was 71.4%. Chronic depressive relapses took a variety of forms and were not limited to dysthymia. Nonetheless, the distinction between chronic and nonchronic forms of depression was relatively sta...

  • Five-year course and outcome of Dysthymic Disorder: A prospective, naturalistic follow-up study.
    The American journal of psychiatry, 2000
    Co-Authors: Daniel N. Klein, Joseph E. Schwartz, Suzanne Rose, Julie B. Leader
    Abstract:

    OBJECTIVE: There have been few naturalistic follow-up studies of Dysthymic Disorder. This study describes the 5-year course and outcome of Dysthymic Disorder.METHOD: The authors conducted a prospective, longitudinal follow-up study of 86 outpatients with early-onset Dysthymic Disorder and 39 outpatients with episodic major depressive Disorder. Follow-ups, conducted 30 and 60 months after entry into the study, rated patients on the Longitudinal Interval Follow-Up Evaluation and the Modified Hamilton Rating Scale for Depression.RESULTS: The estimated 5-year recovery rate from Dysthymic Disorder was 52.9%. Among patients who recovered, the estimated risk of relapse was 45.2% during a mean of 23 months of observation. Patients with Dysthymic Disorder spent approximately 70% of the follow-up period meeting the full criteria for a mood Disorder. During the course of the follow-up the patients with Dysthymic Disorder exhibited significantly greater levels of symptoms and lower functioning and were significantly ...

Pekka Laippala - One of the best experts on this subject based on the ideXlab platform.

  • Survival of elderly Finns suffering from Dysthymic Disorder: a community study
    Social psychiatry and psychiatric epidemiology, 1998
    Co-Authors: Tuula Pulska, Kimmo Pahkala, Pekka Laippala, Sirkka-liisa Kivelä
    Abstract:

    The survival of aged Finns suffering from Dysthymic Disorder (DSM-III criteria) was assessed in two cohorts (60+ yrs and 65+ yrs) in a longitudinal epidemiological study conducted in Ahtari in western Central Finland from 1984 onwards. The mortality of Dysthymic persons (N=214 and N=115) was compared to that of the non-depressed population living in the same municipality (N=982 and N=853). Two follow-up periods (6 yrs and 11.5 yrs) were used for the first cohort, and one (6 yrs) for the second cohort. The Kaplan-Meier procedure and Mantel-Cox statistics followed by Cox proportional hazards models were used in the analyses. The occurrence of Dysthymic Disorder in men was related to higher mortality in both cohorts during all follow-up periods. In women, the occurrence of Dysthymic Disorder was related to higher mortality in the first cohort during the follow-up of 11.5 years, and in the second during the follow-up of 6 years. When age, sex, marital status, education, smoking, physical health and functional abilities were taken into account in the Cox proportional hazards models, high age, male sex, smoking, low educational level, the use of more than two medicines and lowered functional abilities emerged as predictors of mortality in the first cohort during both follow-up periods. In the second cohort, high age, male sex, smoking, poor physical health and lowered functional abilities emerged as predictors. The results suggest that the higher mortality of the aged suffering from Dysthymic Disorder is explained by the high occurrence of somatic diseases and disabilities in Dysthymic persons. They do not suggest that there might exist biochemical factors in the aetiology of Dysthymic Disorders that would increase mortality. Nor do they give any evidence to suggest that Dysthymic Disorders might be precursors of somatic diseases increasing mortality.

  • five year prognosis for Dysthymic Disorder in old age
    International Journal of Geriatric Psychiatry, 1993
    Co-Authors: Sirkka-liisa Kivelä, Kimmo Pahkala, Paivi Kongassaviaro, Erkki Kesti, Pekka Laippala
    Abstract:

    The 5-year prognosis for 199 elderly patients (60 yr+) suffering from Dysthymic Disorder is described. Twenty-nine per cent of the men and 39% of the women recovered, 26% of both were suffering from depression after 5 years, 9% of both had a possible dementia, 32% of the men and 22% of the women had died and 3% of the men and 5% of the women could not be contacted. The outcome did not differ between the sexes or age groups. A poor prognosis among men was related to a low educational level, a non-independent previous occupation, the occurrence of depression previously, a high number of hobbies and the following depressive symptoms: initial and delayed insomnia, retardation and psychomotor agitation. A poor prognosis was also found for those whose functional capacities, hobbies or emotional relations with their wives had declined or who had experienced a pulmonary disease or few or no social growth events during the follow-up. A poor prognosis among women was related to low self-perceived health, high sum score of the Hamilton Rating Scale for Depression, thyroid Disorder and the following depressive symptoms: loss of libido and diurnal variation of symptoms. A poor prognosis was also found for those whose physical health, functional capacities, social participation rate or hobbies had declined or who had experienced a serious disease during the follow-up. A favourable prognosis was found for women who moved to live alone or became more active in taking physical exercise.

  • SOCIAL AND ENVIRONMENTAL FACTORS AND Dysthymic Disorder IN OLD AGE
    Journal of clinical epidemiology, 1992
    Co-Authors: Kimmo Pahkala, Sirkka-liisa Kivelä, Pekka Laippala
    Abstract:

    This community-based epidemiological survey is concerned with relationships between social and environmental factors and Dysthymic Disorder (long-lasting depression according to the DSM-III classification) in a Finnish population aged 60 years or over. A greater proportion of Dysthymic than non-depressed men had retired and did not work at all. The occurrence of Dysthymic Disorders in both men and women was related to retirement because of sickness rather than age, a small number of rooms in their homes, lack of intimate friendships and the occurrence of many long-standing and current social stress factors. The Dysthymic women had lived at their present place of residence for a shorter period than had the non-depressed women. A positive association of Dysthymic Disorders with moving house due to poor health and living in institutions was also found in the men, and with a low number of hobbies and poor social participation in the women. In addition, the Dysthymic women felt their relationships with their spouse, children, daughters-in-law and friends to be more distant than did their non-depressed counterparts. The Dysthymic women also felt that elderly people were not appreciated. The log-linear models showed three interactions for the Dysthymic men and six for the Dysthymic women. The Dysthymic persons reported a significantly larger number of detrimental events of an interpersonal nature than did the non-depressed persons.

  • a one year prognosis of Dysthymic Disorder and major depression in old age
    International Journal of Geriatric Psychiatry, 1991
    Co-Authors: Sirkka-liisa Kivelä, Kimmo Pahkala, Pekka Laippala
    Abstract:

    A prospective follow-up of 199 elderly (60 + yr) patients (65 men and 134 women) suffering from Dysthymic Disorder and 42 elderly (60 + yr) patients (13 men and 29 women) suffering from major depression is described. The mean duration of the follow-up was 15.3 ± 4.3 months for Dysthymic men, 15.2 ± 4.4 months for Dysthymic women, 15.3 ± 4.0 months for major depressive men and 14.0 ± 4.2 months for major depressive women. Forty-three per cent of the Dysthymic men, 38% of the Dysthymic women, 39% of the major depressive men and 48% of the major depressive women had a good outcome. In Dysthymic men, few visiting contacts were associated with poor outcome. In Dysthymic women, poor outcome was associated with many depressive symptoms, low social participation, not living alone, low self-perceived health, intensive diurnal variation of symptoms, low interest in work and activities, low sexual interest, and hypochondrial and compulsive symptoms. In major depressive men, no variable was associated with outcome. In major depressive women, poor outcome was associated with diabetes mellitus, suicidal ideas or attempted suicide, and psychomotor agitation or psychomotor retardation.

John C Markowitz - One of the best experts on this subject based on the ideXlab platform.

  • The epidemiology of chronic major depressive Disorder and Dysthymic Disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
    The Journal of clinical psychiatry, 2010
    Co-Authors: Carlos Blanco, John C Markowitz, Mayumi Okuda, Shang-min Liu, Bridget F. Grant, Deborah S. Hasin
    Abstract:

    OBJECTIVE To examine the prevalence of chronic major depressive Disorder (CMDD) and Dysthymic Disorder, their sociodemographic correlates, patterns of 12-month and lifetime psychiatric comorbidity, lifetime risk factors, psychosocial functioning, and mental health service utilization. METHOD Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). RESULTS The 12-month and lifetime prevalences were greater for CMDD (1.5% and 3.1%, respectively) than for Dysthymic Disorder (0.5% and 0.9%, respectively). Individuals with CMDD and Dysthymic Disorder shared most sociodemographic correlates and lifetime risk factors for major depressive Disorder. Individuals with CMDD and Dysthymic Disorder had almost identically high rates of Axis I and Axis II comorbid Disorders. However, individuals with CMDD received higher rates of all treatment modalities than individuals with Dysthymic Disorder. CONCLUSIONS Individuals with CMDD and Dysthymic Disorder share many sociodemographic correlates, comorbidity patterns, risk factors, and course. Individuals with chronic depressive Disorders, especially those with Dysthymic Disorder, continue to face substantial unmet treatment needs.

  • The impact of comorbid Dysthymic Disorder on outcome in personality Disorders
    Comprehensive psychiatry, 2010
    Co-Authors: David J. Hellerstein, John C Markowitz, Andrew E. Skodol, Eva Petkova, Hui Xie, John G. Gunderson, Carlos M. Grilo, Shirley Yen, Maria T. Daversa, Thomas H. Mcglashan
    Abstract:

    Abstract Objective The goal of our study was to investigate the impact of Dysthymic Disorder (DD), a form of chronic depression, on naturalistic outcome in individuals with personality Disorders (PDs). Method The Collaborative Longitudinal Personality Disorders Study is a cohort initially including 573 subjects with 4 targeted PDs (borderline, avoidant, schizotypal, and obsessive-compulsive) and 95 subjects with major depression but no PD. At baseline, 115 subjects were diagnosed with coexisting DD, of whom 109 (94.8%) were PD subjects. Regression analyses were performed to predict 3 classes of broad clinical outcome after 2 years of prospective follow-up. We hypothesized that DD diagnosis at baseline would be associated with worse outcome on (1) persistence of a PD diagnosis, (2) impairment in psychosocial functioning (as measured by the Longitudinal Interval Follow-up Evaluation), and (3) crisis-related treatment utilization. Results Baseline DD diagnosis was associated with persistence of PD diagnosis at 2 years, particularly for borderline and avoidant PDs. It was associated with worse outcome on global social adjustment, life satisfaction, recreation, and friendships, but not employment or relationship with spouse. Contrary to expectation, DD did not increase suicide attempts, emergency room visits, or psychiatric hospitalizations. Conclusions Comorbidity of DD is associated with persistence of PD diagnosis and with worse outcome on many, but not all, measures of psychosocial functioning.

  • Longitudinal comparison of depressive personality Disorder and Dysthymic Disorder
    Comprehensive psychiatry, 2005
    Co-Authors: John C Markowitz, David J. Hellerstein, Andrew E. Skodol, Eva Petkova, Hui Xie, Jianfeng Cheng, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan
    Abstract:

    Background: Few studies have compared the related diagnostic constructs of depressive personality Disorder (DPD) and Dysthymic Disorder (DD). The authors attempted to replicate findings of Klein and Shih in longitudinally followed patients with personality Disorder or major depressive Disorder (MDD) in the Collaborative Longitudinal Personality Disorders Study. Methods: Subjects (N = 665) were evaluated at baseline and over 2 years (n = 546) by reliably trained clinical interviewers using semistructured interviews and self-report personality questionnaires. Results: Only 44 subjects (24.6% of 179 DPD and 49.4% of 89 early-onset Dysthymic subjects) met criteria for both Disorders at baseline. Depressive personality Disorder was associated with increased comorbidity of some axis I anxiety Disorders and other axis II diagnoses, particularly avoidant (71.5%) and borderline (55.9%) personality Disorders. Depressive personality Disorder was associated with low positive and high negative affectivity on dimensional measures of temperament. Depressive personality Disorder subjects had lower likelihood of remission of baseline MDD at 2-year follow-up, whereas DD subjects did not. The DPD diagnosis appeared unstable over 2 years of followup, as only 31% (n = 47) of 154 subjects who had DPD at baseline and also had follow-up assessment met criteria on blind retesting. Limitations: Results from this sample may not generalize to other populations. Conclusions: Depressive personality Disorder and Dysthymic Disorder appear to be related but differ in diagnostic constructs. Its moderating effect on MDD and predicted relationship to measures of temperament support the validity of DPD, but its diagnostic instability raises questions about its course, utility, and measurement.

  • Early- versus late-onset Dysthymic Disorder: comparison in out-patients with superimposed major depressive episodes
    Journal of Affective Disorders, 1999
    Co-Authors: Daniel N. Klein, John C Markowitz, Alan F. Schatzberg, James P. Mccullough, Martin B. Keller, Frank Dowling, Daniel Goodman, Robert H Howland, Christine Smith, Robert J. Miceli
    Abstract:

    Background: This study examined the validity of the early-late onset subtyping distinction in Dysthymic Disorder. Methods: Participants were 340 out-patients meeting DSM-III-R criteria for dysthymia and a concurrent major depressive episode (MDE). The sample was drawn from a 12-site double-blind randomized parallel group trial comparing the efficacy of sertraline and imipramine in the treatment of chronic depression. All patients received comprehensive evaluations using semi-structured interviews and rating scales. Results: 73% of the sample met criteria for the early-onset, and 27% for the late-onset, subtype. The early-onset patients had a significantly longer index MDE, significantly higher rates of personality Disorders and lifetime substance use Disorders, and a significantly greater proportion had a family history of mood Disorder. The subgroups did not differ in symptom severity or functional impairment at baseline, nor in response to a 12-week trial of antidepressants. Limitations: Further work is needed to extend these findings to Dysthymic Disorder without superimposed MDEs. Conclusions: These results support the distinction between early-onset and late-onset Dysthymic Disorder.

  • interpersonal psychotherapy for Dysthymic Disorder
    1998
    Co-Authors: John C Markowitz
    Abstract:

    Overview of Dysthymic Disorder Dysthymic Disorder Treatment of Dysthymic Disorder Interpersonal Psychotherapy of Dysthymic Disorder Overview of Interpersonal Psychotherapy Interpersonal Psychotherapy for Dysthymic Disorder (IPT-D) Case Examples Complex Cases of Dysthymic Disorder The "PostDysthymic" Patient How Long is Long Enough? For Family Members and Significant Others.