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Dysthymia. The importance of an early diagnosis and an efficient treatment

Published online by Cambridge University Press:  23 March 2020

A. Duque Domínguez*
Affiliation:
Complejo Asistencial de Ávila, Servicio de Psiquiatría, Ávila, Spain
R. Duque Domínguez
Affiliation:
Hospital Universitario de Fuenlabrada, Servicio de Psiquiatría, Madrid, Spain
C. García Montero
Affiliation:
Complejo Asistencial de Ávila, Servicio de Psiquiatría, Ávila, Spain
L. Martín Díaz
Affiliation:
Complejo Asistencial de Ávila, Servicio de Psiquiatría, Ávila, Spain
M. Palomo Monge
Affiliation:
Complejo Hospitalario de Talavera de la Reina, Servicio de Psiquiatría, Talavera de la Reina Toledo, Spain
F. de la Torre Brasas
Affiliation:
Complejo Asistencial de Ávila, Servicio de Psiquiatría, Ávila, Spain
N. Echeverría Hernández
Affiliation:
Complejo Asistencial de Ávila, Servicio de Psiquiatría, Ávila, Spain
M.D.M. Lázaro Redondo
Affiliation:
Complejo Asistencial de Ávila, Servicio de Psiquiatría, Ávila, Spain
*
*Corresponding author.

Abstract

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Introduction

Dysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. It is important to distinguish it from other types of depression, as early as possible. The therapeutic management of dysthymia is similar to the one used in major depressive disorder.

Objectives

We report the case of a female patient aged 45, diagnosed with depressive disorder not otherwise specified since she was 20. Her psychopathological progress has gradually become aggravated, having now longer periods of depressive mood and an important tendency towards isolation.

Methodology

The patient is admitted to the Psychiatric Day Hospital presenting with important depressive symptoms. After various antidepressants were withdrawn, lithium salts were introduced. It is then that the patient starts improving her mood.

Results

– Dysthymia (F34.1).

– Mixed and other personality disorders (F61.0).

Conclusions

In spite of having an appropriate pharmacological, unfortunately, antidepressants improve dysthymia just in 50–70% of patients. Antidepressants resistant dysthymia cases have been studied. In those cases, it has been necessary to add lithium or thyroxine. This confirms that, when it comes to this disorder, there are many neurochemical mechanisms involved, given the positive response to the combination of drugs, notwithstanding the severity of the adverse effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV494
Copyright
Copyright © European Psychiatric Association 2016
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