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Expert Review of Neurotherapeutics Jul 2024Despite its milder severity, the chronic nature of dysthymia leads to significant impairments and functional limitations. The treatment of dysthymia has received... (Review)
Review
INTRODUCTION
Despite its milder severity, the chronic nature of dysthymia leads to significant impairments and functional limitations. The treatment of dysthymia has received considerably less research attention compared to major depressive disorder (MDD).
AREAS COVERED
The authors have conducted a comprehensive review on the treatment of dysthymia. Their primary objective was to identify therapeutic options that have demonstrated genuine efficacy. To do this, they searched the PubMed database, without any time restrictions, to retrieve original studies. The samples were exclusively comprised individuals diagnosed with dysthymia according to the diagnostic criteria outlined in DSM-III, DSM-III-R, DSM-IV, or DSM-IV-TR.
EXPERT OPINION
Within the realm of dysthymia treatment, several antidepressants, including imipramine, sertraline, paroxetine, minaprine, moclobemide, and amineptine, in addition to the antipsychotic agent amisulpride, have demonstrated superiority over placebo. In certain studies, psychotherapeutic interventions did not distinguish themselves significantly from pharmacological treatments and failed to exhibit greater efficacy than a placebo. However, these findings remain inconclusive due to the limited number of studies and substantial methodological limitations prevalent in a significant proportion of them. Limitations include factors like small sample sizes, the absence of placebo comparisons, and a lack of study blinding.
Topics: Humans; Dysthymic Disorder; Antidepressive Agents; Antipsychotic Agents; Psychotherapy
PubMed: 38805342
DOI: 10.1080/14737175.2024.2360671 -
Journal of Affective Disorders Jul 2023
Topics: Humans; Dysthymic Disorder; Global Burden of Disease; Quality-Adjusted Life Years; Life Expectancy; Global Health; Incidence
PubMed: 37084969
DOI: 10.1016/j.jad.2023.04.024 -
Gut and Liver May 2024Irritable bowel syndrome (IBS) is considered a stress disorder characterized by psychological and gastrointestinal dysfunction. IBS patients not only suffer from... (Review)
Review
Irritable bowel syndrome (IBS) is considered a stress disorder characterized by psychological and gastrointestinal dysfunction. IBS patients not only suffer from intestinal symptoms such as abdominal pain, diarrhea, or constipation but also, experience dysthymic disorders such as anxiety and depression. Studies have found that corticotropin-releasing hormone plays a key role in IBS with comorbid dysthymic disorders. Next, we will summarize the effects of corticotropin-releasing hormone from the central nervous system and periphery on IBS with comorbid dysthymic disorders and relevant treatments based on published literatures in recent years.
Topics: Irritable Bowel Syndrome; Humans; Corticotropin-Releasing Hormone; Dysthymic Disorder; Comorbidity
PubMed: 37551453
DOI: 10.5009/gnl220346 -
Brain Sciences Dec 2023(1) Background: Bipolar disorder (BD) is divided into type I (BD-I) and type II (BD-II). Polarity at onset (PO) is a proposal to specify the clinical course of BD, based...
(1) Background: Bipolar disorder (BD) is divided into type I (BD-I) and type II (BD-II). Polarity at onset (PO) is a proposal to specify the clinical course of BD, based on the type of the first episode at disorder onset-depressive (D-PO) or manic (M-PO). At the same time, affective temperaments represent preexisting variants of the spectrum of affective disorders. Our objectives were to investigate the hypothesis that temperament may exert an influence on PO, and that this factor can serve as an indicator of the forthcoming course of the disorder, carrying significant therapeutic implications. (2) Methods: We included 191 patients with BD and examined clinical variables and temperament; the latter was assessed using the short version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire (TEMPS-A-39-SV). We tested the associations between these variables and PO using standard univariate/bivariate methods followed by multivariate logistic regression models. (3) Results: 52.9% of the sample had D-PO and 47.1% had M-PO. D-PO and M-PO patients scored higher for dysthymic and hyperthymic temperaments, respectively ( < 0.001). Also, they differed in BD subtypes, age at first affective episode, illness duration, number of depressive episodes, seasonality, suicide risk, substance use, lithium, and benzodiazepine use ( < 0.05). Only BD-II and age at first depressive episode were predictors of D-PO, whereas BD-I, age at first manic/hypomanic episode, and hyperthymic temperament were predictors of M-PO ( < 0.01). (4) Conclusions: Our findings point to the importance of carefully assessing temperament and PO in patients with BD, to better predict the clinical course and tailor therapeutic interventions to individual patients' needs.
PubMed: 38248232
DOI: 10.3390/brainsci14010017 -
Frontiers in Oncology 2023Sex-related discrepancies in the prognosis of oral cancer patients have not been clarified. This study aimed to assess survival outcomes and potential prognostic factors...
BACKGROUND
Sex-related discrepancies in the prognosis of oral cancer patients have not been clarified. This study aimed to assess survival outcomes and potential prognostic factors in female and male patients with oral cancer.
METHODS
A retrospective search of the TriNetX network (TriNetX, Cambridge, Massachusetts, USA) was conducted to identify patients diagnosed with oral cancer (International Classification of Diseases (ICD)-10 codes C02-C06), within the past 20 years from the access date April 21, 2023. Patients were categorized according to sex (female vs. male). Following matching for age and risk factors such as nicotine dependence and alcohol abuse, Kaplan-Meier analysis was performed and risk, odds, and hazard ratios were calculated. Outcome variables were five-year disease-free survival (DFS) and overall survival (OS). Additionally, the female and male patient cohort were compared with regard to the novel diagnosis of depression (depressive episode, major depressive disorder, dysthymic disorder) after the tumor diagnosis.
RESULTS
A total of 77,348 patients were assessed. After propensity score matching, 26,578 male and 26,578 female patients were included in each group (mean age 63 years). DFS (71.92% in females vs. 68.29% in males; hazard ratio (HR) 0.870; < 0.001) and OS (77.08% in females vs. 71.74% in males; HR 0.793; < 0.001) were significantly higher in the female cohort. However, in patients diagnosed with depression after the initial cancer diagnosis (N = 4,824), survival was worse in female patients compared to male patients (82.48% in females vs. 86.10% in males; HR 1.341; < 0.001).
CONCLUSION
This retrospective case-control study showed that females with oral cancer had a better DFS and OS than males. However, survival in females with a newly diagnosed depression after the oral cancer diagnosis was worse compared to those of male oral cancer patients. Depression may be a relevant prognostic factor that contributes to sex disparities in oral cancer patients.
PubMed: 37901332
DOI: 10.3389/fonc.2023.1248926 -
Revista Medica Del Instituto Mexicano... Sep 2023Traditionally, psychopathology has been related to suicide risk, furthermore if we bear in mind that the recent meta-analysis on the relationship between some mental...
BACKGROUND
Traditionally, psychopathology has been related to suicide risk, furthermore if we bear in mind that the recent meta-analysis on the relationship between some mental disorders and the risk of suicide attempt are inconclusive, and have been performed with non-clinical samples.
OBJECTIVE
To establish the psychopathological differences between female adolescent patients with and without suicide attempt.
MATERIAL AND METHODS
Comparative, prospective, correlational and cross-sectional study. A sample of 50 female participants was used, divided into 2 groups: one of cases, (n = 25), made up of female patients between 15 and 19 years of age with suicide attempt, and a control group of pairs (n = 25) with no history of suicide attempt. The following instruments were applied: the Plutchik Impulsivity Scale, the Beck Hopelessness Scale, the K-Sads-PL, the Beck Suicidal Ideation Scale, and the Hamilton Depression Scale.
RESULTS
A greater presence of the disorders evaluated was found: major depressive disorder, dysthymic disorder, generalized anxiety disorder and panic disorder in the group with suicide attempt. Furthermore, the case group obtained higher mean scores on the Beck Hopelessness Scale, the Beck Suicidal Ideation Scale, the Hamilton Depression Scale and the Plutchik Impulsivity Scale.
CONCLUSIONS
The results agree with most of previous studies. It is suggested to carry out preventive interventions in cases where a considerably increased risk is detected.
Topics: Humans; Female; Adolescent; Suicide, Attempted; Depressive Disorder, Major; Cross-Sectional Studies; Prospective Studies; Mental Disorders; Suicidal Ideation; Risk Factors
PubMed: 37768952
DOI: 10.5281/zenodo.8316441 -
American Journal of Medical Genetics.... Apr 2024Boven published, in 1915, his MD thesis at the University of Lausanne in which he examined 60 3- to 4-generation pedigrees ascertained from admitted patients with... (Review)
Review
Boven published, in 1915, his MD thesis at the University of Lausanne in which he examined 60 3- to 4-generation pedigrees ascertained from admitted patients with dementia praecox (DP) and manic-depressive insanity (MDI). He asked three questions: (i) were DP and MDI hereditary? (ii) were they the same or distinct conditions? and (iii) were they Mendelian disorders? Based on the rarity of environmental precipitants severe enough to cause disorder onset and the pattern of disorders in relatives, Boven concluded that both disorders were inherited. He found that MDI largely ran in families through direct transmission across generations while DP was only common in collateral relatives. Both pedigrees contained a substantial number of "psychopathic" (personality disordered) relatives in which DP and MDI pedigrees typically had, respectively, paranoid, and dysthymic/cyclothymic features. Boven concludes that their inheritance is largely distinct but not exclusive, as some pedigrees contained cases of both disorders. With assistance from Wilhelm Weinberg, Boven applied algebraic models with proband correction to rates of DP and MDI in sibships and found the results inconsistent with Mendelian transmission. His study represents among the first examinations, using "modern" methods, of the familial relationship between DP and MDI and the first published in French.
Topics: Male; Humans; Schizophrenia; Heredity; Psychotic Disorders; Bipolar Disorder; Family
PubMed: 37858604
DOI: 10.1002/ajmg.b.32961 -
Journal of Affective Disorders Oct 2023Despite the high prevalence of alcohol use disorders (AUDs) in Korea, few studies have been conducted on the temporal priority with comorbid mental disorders. We...
BACKGROUND
Despite the high prevalence of alcohol use disorders (AUDs) in Korea, few studies have been conducted on the temporal priority with comorbid mental disorders. We investigated the temporal priority of lifetime AUDs and comorbid mood and anxiety disorders among the general population of Korea.
METHODS
Data of 18,807 respondents aged 18 years or older, collected from three national epidemiological surveys comprising face-to-face interviews using the Korean version of the Composite International Diagnostic Interview for DSM-IV mental disorders. For each mood or anxiety disorder, the extent to which one mental disorder precedes another was investigated by calculating the proportion of primary AUDs by that of primary mood or anxiety disorder.
RESULTS
Regarding alcohol dependence, dysthymic disorder is 5.6 times more likely to occur before alcohol dependence. Moreover, generalized anxiety disorder, social phobia, and specific phobia are 3.6 times, 4.5 times, and 6.3 times more likely to occur before, respectively. Regarding alcohol abuse, specific phobia is 6.3 times more likely to occur before, whereas major depressive disorder is two times more likely to occur after. Moreover, the lag times between primary alcohol abuse and subsequent mood or anxiety disorders were longer than those between primary alcohol dependence and the latter.
LIMITATIONS
The age of onset might be subject to recall bias. The presence of non-respondents could have influenced the results.
CONCLUSION
We need to recognize that one of the mental disorders could lead to another and consider it in the management of people with AUDs or mood and anxiety disorders.
PubMed: 37437734
DOI: 10.1016/j.jad.2023.07.051 -
BMC Public Health Jun 2024Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia...
BACKGROUND
Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia is gaining attention due to its similarity in clinical severity and disability to major depressive disorders (MDD). However, national epidemiological data on the burden of disease and risk factors of MDD and dysthymia in China are scarce.
METHODS
This study aimed to evaluate and compare the incidence, prevalence, and disability-adjusted life-years (DALYs) caused by MDD and dysthymia in China between 1990 and 2019. The temporal trends of the depressive disorder burden were evaluated using the average annual percentage change. The comparative risk assessment framework was used to estimate the proportion of DALYs attributed to risk factors, and a Bayesian age-period-cohort model was applied to project the burden of depressive disorders.
RESULTS
From 1990 to 2019, the overall age-standardized estimates of dysthymia in China remained stable, while MDD showed a decreasing trend. Since 2006, the raw prevalence of dysthymia exceeded that of MDD for the first time, and increased alternately with MDD in recent years. Moreover, while the prevalence and burden of MDD decreased in younger age groups, it increased in the aged population. In contrast, the prevalence and burden of dysthymia remained stable across different ages. In females, 11.34% of the DALYs attributable to depressive disorders in 2019 in China were caused by intimate partner violence, which has increasingly become prominent among older women. From 2020 to 2030, the age-standardized incidence, prevalence, and DALYs of dysthymia in China are projected to remain stable, while MDD is expected to continue declining.
CONCLUSIONS
To reduce the burden of depressive disorders in China, more attention and targeted strategies are needed for dysthymia. It's also urgent to control potential risk factors like intimate partner violence and develop intervention strategies for older women. These efforts are crucial for improving mental health outcomes in China.
Topics: Humans; China; Dysthymic Disorder; Female; Adult; Middle Aged; Male; Young Adult; Depressive Disorder, Major; Adolescent; Prevalence; Aged; Risk Factors; Incidence; Disability-Adjusted Life Years; Bayes Theorem; Forecasting
PubMed: 38872130
DOI: 10.1186/s12889-024-18943-7 -
The British Journal of Clinical... Jun 2024Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is the first therapy specifically developed for persistent depressive disorder (PDD). This study aimed to...
Identifying predictors of a favourable outcome for outpatients with a persistent depressive disorder treated with Cognitive Behavioural Analysis System of Psychotherapy: A prospective cohort study.
OBJECTIVES
Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is the first therapy specifically developed for persistent depressive disorder (PDD). This study aimed to identify predictors of favourable treatment outcome after group CBASP and assess change in depression severity over 24 weeks.
DESIGN
A prospective cohort study was conducted in patients with PDD treated with group-CBASP.
METHODS
Outcomes were depression severity measured by the Inventory of Depression Severity-self-report (IDS-SR) after 6 and 12 months. Potential predictors investigated were baseline depression severity, prior antidepressant use, age, family status, income source, age of onset and childhood trauma. Multivariate logistic regression was performed to assess their effects with a ≥25% IDS-SR score decrease as the dependent variable.
RESULTS
The IDS-SR score (range 0-84) significantly decreased from 37.78 at start to 33.45 at 6 months, an improvement which was maintained at 12 months. Having paid work and no axis I comorbidity significantly predicted favourable response. In the groups without a favourable outcome predictor a substantial percentage still showed at least partial response (16.7% and 19.2%).
CONCLUSIONS
Source of income and axis I comorbidity were predictors of response to group-CBASP. Within the group without favourable outcome predictors, a subgroup showed at least partial response. These results suggest that group-CBASP has promise for patients who do not respond to standard treatments. Future studies should include outcome measures that take into account comorbidity and other clinically relevant changes, such as social functioning.
Topics: Humans; Male; Female; Adult; Cognitive Behavioral Therapy; Middle Aged; Prospective Studies; Treatment Outcome; Depressive Disorder; Outpatients; Severity of Illness Index; Psychotherapy, Group; Young Adult; Aged
PubMed: 38312067
DOI: 10.1111/bjc.12454