Clinical features of dysthymia and age: a clinical investigation
@article{Bellino2001ClinicalFO, title={Clinical features of dysthymia and age: a clinical investigation}, author={Silvio Bellino and Luca Patria and Simona Ziero and Giuseppe Rocca and Filippo Bogetto}, journal={Psychiatry Research}, year={2001}, volume={103}, pages={219-228} }
9 Citations
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Dysthymia is not uncommon among depressed elderly outpatients who present for treatment, and the DSM-III-R subtyping of dysthymic disorder into early/late onset and primary/secondary may not apply to the elderly.
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Drug treatment of depressive conditions in the elderly is currently based on new antidepressants that have an improved adverse effect profile compared with some of the older agents, but no specific data are available concerning the psychotherapy of dysthymia in this age group.
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Late life dysthymia is less associated with axes 1 and 2 comorbidity but is associated with significant degrees of physical impairment and interventions must be delivered at this level.
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Dysthymia and psychosocial outcomes improved with sertraline and imipramine treatment, and newer antidepressant agents may alter the potential for pharmacotherapy interventions in this vulnerable population.
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Findings should not be surprising to practicing psychiatrists, for it has often been observed that persons in the early stages of dementia of the Alzheimer's type experience a substantial depressed mood, a depression that may well respond to antidepres-sant therapy, but as the disorder progresses the mood disturbance is no longer an integral part of the dementia symptoms.
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It is submitted that SSRIs such as fluoxetine appear broadly efficacious in areas previously deemed to be the domain of formal psychotherapy, and 3 of 4 patients immersed in gloom for much of their lives achieved for the first time good to superior levels of functioning that were maintained for an average of 5 years.
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The current findings on personality disorders reinforce the view that DD in elderly patients is typically a different disorder from DD in young adults, and that young adults with DD have been shown consistently to have personality disorders at high frequency.
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A World Health Organization meeting on dysthymia in neurological disorders was held in Geneva, 1-3 July 1996 to address this topic, providing direction and opportunity for future studies in the under-recognized and under-investigated relationship between dysthysymia and neurological disorders.
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There appears to be a core of symptoms and functional impairment that generalizes across the age span and growing older appears to have an impact on the nature of what it means to have dysthymia.