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Dysthymia Disorder

Treatments

COMBINATION PSYCHOTHERAPY AND MEDICATION

Treatment Summary: Depression-focused Cognitive Behavioral Therapy (CBT) or Interpersonal Psychotherapy (IPT) and antidepressant medication have proven to be most successful for dysthymia. This combination targets the depressive symptoms and social functioning. The CBT approach offers a therapeutic environment customized to meet the patient's need for unconditional acceptance and support. The pace of therapy and functioning level should be determined by the client. This allows the client to set realistic and attainable goals that bring them back to their normal level of functioning. IPT is a brief psychotherapy based on psychoeducation that focuses on the "here and now" that connects feelings with events. Due to the chronic depression that most clients with dysthymia experience, antidepressant medications such as serotonin re-uptake inhibitors (SSRIs) are usually prescribed (i.e. Prozac, Paxil, Zoloft, etc.). SSRIs work by raising the level of the chemical serotonin in the brain, in turn, alters mood, emotions, and impulses.

  • Reference: Park, R., & Goodyer, I. (2000). Clinical guidelines for depressive disorders in childhood and adolescence. European Child & Adolescent Psychiatry, 9(3), 147. Retrieved from Psychology and Behavioral Sciences Collection database.
  • Submitter: N/A

Focus issues on pathology, Psychotherapy, Pharmacology and combination treatment

Treatment Summary: The studies referenced below carried out various therapeutic approaches (psychotherapy, pharmacology, focus issues on pathology and combination sources) for dysthymia disorder. The key issues of dysthymic disorder are much more related to the characteristics of major depression, chronic depression mood, episodic depression and mood depression. The dysthymic disorders often associated with illnesses/psychiatric disorders and other common comorbidity such as alcohol abuse, anxiety disorders, personality disorder, substance abuse disorder and others disorders. The patient with dysthymic disorder mostly respond effectively to antidepressant medication must be persistent and willingness to follow through with accurate doses given for a long duration, in order to attain a full remission. Patients need to focus on the early-onset and late-onset signs, symptoms and risks factors of dysthymia. Some of the common symptoms that are connected to dysthymia are sleep change, psychomotor change, anhedonia, depressed mood, fatigue, difficulties in guilt, suicidal thoughts, feelings of worthlessness etc. The main goal of therapeutic approaches for dysthymia is to show responses to treatment, improvement and able to manage the recovery to the full point of remission.

  • Reference: Friedman, R. A., Mitchell, J., & Kocsis, J. H. (1995). Retreatment for relapse following desipramine discontinuation in dysthymia. The American Jounal of Psychiatry, 152(6), 926-928. Retrieved Sept 21, 2012 from http://www.proquest
  • Submitter: N/A

Psychotherapy, Cognitive Behavioral Therapy and Pharmacological Treatment

Treatment Summary: In the study referenced below effective treatments for dysthymic disorder we tested. The effective treatments were to 1. begin by evaluating client (stressor, family functioning, school functioning, and coping ability). The source also states the importance of intervention. Many of the intereventions were similar to those implemented in individuals with depression. The interventions should include but are not limited to; individual psychotherapy, family therapy and pharmacological treatment. The pharmacological treatment aims to modify maladaptive personality organization that may determine long-term change in mood. The response to psychotherapy varies based on various factors; age of onset, severity of depression, and whether the disorder is comorbid with other disorders. Most used treatments in SUMMARY: 1. Psychological treatment 2. Support Systems 3. Cognitive Behavioral Therapy 4. Family Therapy 4. Interpersonal/Psychodynamic Psychotherapy 5. Prevention Programs (targeted/universal) -help with primary prevention and recurrence 6. Pharmacological (antidepressants/SSRI) -ex. fluoxetine, fluvoxamine, paroxetine, citalopram, sertraline.

  • Reference: Nobile, M., Cataldo, G. M., Marino, C., & Molteni, M. (2003). Diagnosis and Treatment of Dysthymia in Children and Adolescents. CNS Drugs, 17(13), 927-946.
  • Submitter: Pamela Johnson

Cognitive Behavior Therapy (CBT)

Treatment Summary: Cognitive Behavioral Therapy (CBT) is a structured time limited and directive therapy that focuses on changing thoughts and belief systems (Zalaquett, & Stens, 2006). Notably, the goals of CBT are to change thoughts, to improve skills, and to adjust emotional states that play a part to psychopathology (Zalaquett, & Stens, 2006). The techniques of CBT challenges the person's thoughts of self-doubt, looks for better ways to improve coping skills, changes the way information is processed within the mind, and confronts tarnished belief systems. CBT may consist of having the person complete self monitoring exercises, increase positive self-statements, challenge the person's irrational or self destructive thoughts, and challenge the person's thought processes and misguided beliefs so to alleviate depression by developing rewarding and reinforcing perceptions and experiences (Zalaquett, & Stens, 2006). Thus, persons with dysthymia using CBT as a therapeutic treatment option may be require to attend positive social events, engage in positive talk about oneself, identify and change distorted thoughts, set goals, and promote more positive ways to solve problems.

  • Reference: Zalaquett, C.P., & Stens, A.N. (2006). Psychosocial treatments for major depression and dysthymia in older adults: A review of the research literature. Journal of Counseling and Development, (84)2, 192-201
  • Submitter: N/A

Psychotherapy and Pharmacotherapy

Treatment Summary: Since children with dysthymia often have co-morbid symptoms it is advisable that the treatment plan consist of multiple levels including: individual psychotherapy (Cognitive Behavioral Treatment and Interpersonal Treatment), family therapy, education, and medication. Fluoxetine is the only drug approved by the US FDA to treat major depressive disorder in children over 7 years of age so this is the commonly prescribed medication for dysthymia.

  • Reference: Nobile, M., Cataldo, G.M., Marino, C., & Molteni, M. (2003). Diagnosis and treatment of dysthymia in children and adolescents. CNS Drugs, 17 (13), 927 - 946. Retrieved January 20, 2011, from http://web.ebscohost.com
  • Submitter: Lan Carter