Dysthymia in Clinical Practice

1995 ◽  
Vol 166 (2) ◽  
pp. 174-183 ◽  
Author(s):  
Hagop S. Akiskal ◽  
Jorge Alberto Costa e Silva ◽  
Allen Frances ◽  
Hugh L. Freeman ◽  
Martin B. Keller ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Working Group ◽  
Diagnostic Systems ◽  
Major Depressive ◽  
Positive Approach ◽  
Literature Searches ◽  
Double Depression

BackgroundDysthymia has been reconceptualised in recent years from a personality disorder to a chronic affective disorder. It is incorporated into both the DSM and ICD diagnostic systems. Method. The members of the WPA Dysthymia Working Group combined the results of their manual literature searches with a search using Medline.ResultsAvailable data are summarised under the headings of classification, epidemiology, validity, comorbidity, course and outcome, pharmacotherapy and psychotherapy. The coexistence of major depressive disorder, constituting ‘double depression’ is of particular importance.ConclusionsImproved knowledge of this disorder has led to a more positive approach to treatment, in which antidepressants can usefully be complemented by psychosocial measures. A high proportion of cases remain unrecognised in most populations, leading to prolonged morbidity and distress, much of which is now treatable.

scholarly journals White matter disturbances in major depressive disorder: a coordinated analysis across 20 international cohorts in the ENIGMA MDD working group

2019 ◽  
Vol 25 (7) ◽  
pp. 1511-1525 ◽  
Author(s):  
Laura S. van Velzen ◽  
Sinead Kelly ◽  
Dmitry Isaev ◽  
Andre Aleman ◽  
Lyubomir I. Aftanas ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
White Matter ◽  
Depressive Disorder ◽  
Working Group ◽  
Major Depressive

scholarly journals Subcortical brain alterations in major depressive disorder: findings from the ENIGMA Major Depressive Disorder working group

2015 ◽  
Vol 21 (6) ◽  
pp. 806-812 ◽  
Author(s):  
L Schmaal ◽  
◽  
D J Veltman ◽  
T G M van Erp ◽  
P G Sämann ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Working Group ◽  
Major Depressive ◽  
Subcortical Brain

Major depressive disorder in the general hospital: adaptation of clinical practice guidelines

2003 ◽  
Vol 25 (3) ◽  
pp. 185-193 ◽  
Author(s):  
Rachel Voellinger ◽  
Alexandre Berney ◽  
Pierre Baumann ◽  
Jean-Marie Annoni ◽  
Christian Bryois ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Depressive Disorder ◽  
General Hospital ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Major Depressive

Personality disorders and depression

2002 ◽  
Vol 32 (6) ◽  
pp. 1049-1057 ◽  
Author(s):  
M. FAVA ◽  
A. H. FARABAUGH ◽  
A. H. SICKINGER ◽  
E. WRIGHT ◽  
J. E. ALPERT ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Personality Disorders ◽  
Antidepressant Treatment ◽  
Significant Proportion ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Before And After

Background. Personality disorders (PDs) were assessed among depressed out-patients by clinical interview before and after antidepressant treatment with fluoxetine to assess the degree of stability of PD diagnoses and determine whether changes in PD diagnoses across treatment are related to the degree of improvement in depressive symptoms.Method. Three hundred and eighty-four out-patients (55% women; mean age = 39.9±10.5) with major depressive disorder (MDD) diagnosed with the SCID-P were enrolled into an 8 week trial of open treatment with fluoxetine 20 mg/day. The SCID-II was administered to diagnose PDs at baseline and endpoint.Results. A significant proportion (64%) of our depressed out-patients met criteria for at least one co-morbid personality disorder. Following 8 weeks of fluoxetine treatment, there was a significant reduction in the proportion of patients meeting criteria for avoidant, dependent, passive-aggressive, paranoid and narcissistic PDs. From baseline to endpoint, there was also a significant reduction in the mean number of criteria met for paranoid, schizotypal, narcissistic, borderline, avoidant, dependent, obsessive–compulsive, passive aggressive and self-defeating personality disorders. While changes in cluster diagnoses were not significantly related to improvement in depressive symptoms, there were significant relationships between degree of reduction in depressive symptoms (percentage change in HAM-D-17 scores) and degree of change in the number of criteria met for paranoid, narcissistic, borderline and dependent personality disorders.Conclusions. Personality disorder diagnoses were found to be common among untreated out-patients with major depressive disorder. A significant proportion of these patients no longer met criteria for personality disorders following antidepressant treatment, and changes in personality disorder traits were significantly related to degree of improvement in depressive symptoms in some but not all personality disorders. These findings suggest that the lack of stability of PD diagnoses among patients with current MDD may be attributable in part to a direct effect of antidepressant treatment on behaviours and attitudes that comprise PDs.

Effect of agomelatine treatment on C-reactive protein levels in patients with major depressive disorder: an exploratory study in “real-world,” everyday clinical practice

CNS Spectrums ◽  
2016 ◽  
Vol 22 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Domenico De Berardis ◽  
Michele Fornaro ◽  
Laura Orsolini ◽  
Felice Iasevoli ◽  
Carmine Tomasetti ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Real World ◽  
Level Variation ◽  
C Reactive Protein ◽  
Major Depressive ◽  
Everyday Clinical Practice ◽  
Reactive Protein

ObjectiveAgomelatine is a newer antidepressant but, to date, no studies have been carried out investigating its effects on C-reactive protein (CRP) levels in major depressive disorder (MDD) before and after treatment. The present study aimed (i) to investigate the effects of agomelatine treatment on CRP levels in a sample of patients with MDD and (ii) to investigate if CRP variations were correlated with clinical improvement in such patients.Methods30 adult outpatients (12 males, 18 females) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnosis of MDD were recruited in “real-world,” everyday clinical practice and treated with a flexible dose of agomelatine for 12 weeks. The Hamilton Rating Scale for Depression (HAM-D) and the Snaith-Hamilton Pleasure Scale (SHAPS) were used to evaluate depressive symptoms and anhedonia, respectively. Moreover, serum CRP was measured at baseline and after 12 weeks of treatment.ResultsAgomelatine was effective in the treatment of MDD, with a significant reduction in HAM-D and SHAPS scores from baseline to endpoint. CRP levels were reduced in the whole sample, with remitters showing a significant difference in CRP levels after 12 weeks of agomelatine. A multivariate stepwise linear regression analysis showed that higher CRP level variation was associated with higher baseline HAM-D scores, controlling for age, gender, smoking, BMI, and agomelatine dose.ConclusionsAgomelatine’s antidepressant properties were associated with a reduction in circulating CRP levels in MDD patients who achieved remission after 12 weeks of treatment. Moreover, more prominent CRP level variation was associated with more severe depressive symptoms at baseline.

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