Depressive Symptoms in Children and Adolescents with Dysthymic Disorder

Abstract

This report examines clinical features of ‘pure’ dysthymic disorder (DD, without superimposed major depressive disorder, MDD) in a sample of children and adolescents. Profiles of symptomatology and comorbidity as a function of age and gender are described. The sample consisted of 48 subjects (22 males, 26 females, age range 7–18 years, mean age 12.1 years) screened from consecutively referred children and adolescents. All subjects were comprehensively diagnosed with structured diagnostic interviews (Schedule for Affective Disorders and Schizophrenia for School Age, Diagnostic Interview for Children and Adolescents-Revised), according to DSM-IV criteria. Depressed mood, irritability, loss of energy and fatigue, guilt and low self-esteem were present in more than 70% of the subjects. Differences in symptomatic profile between males and females were not significant. Children showed less symptoms than adolescents, but the symptomatic profile was comparable (only anhedonia was significantly more frequent in adolescents). Anxiety disorders were more commonly comorbid with DD, especially separation anxiety disorder in children (33%) and generalised anxiety disorder in adolescents (67%). Externalising disorders were less frequently represented in our sample (14%). An early diagnosis of ‘pure’ DD before the first episode of MDD is crucial for a timely intervention.

Phenomenology and Comorbidity of Dysthymic Disorder in 100 Consecutively Referred Children and Adolescents: Beyond DSM-IV

“…Our previous analyses of children and adolescents assessed with DICA-R revealed a good interrater reliability for the diagnosis of DD, as well as for the identification of particular symptoms (K > 0.75) (23). The individual reliability for the specific items, that is, the property of each question to obtain the same answer when the item is reformulated, was good for all the items.…”

Anxiety Comorbidity in Referred Children and Adolescents with Dysthymic Disorder

“…The various types of cases were randomly allocated between interviewers. Our previous analyses on a sample of children and adolescents assessed with DICA-R revealed a good interrater reliability for the diagnosis of GAD and DD (r 1 0.70) [19,20]. We have further examined the interrater reliability regarding the identification of particular symptoms using the diagnostic interviews.…”

“…Kovacs et al [18] found anxiety disorders in 40% of children and adolescents with DD. In the study performed by Masi et al [19], GAD was reported in more than half of the dysthymic children and adolescents and a depressive disorder in about 60% of the GAD patients [20]. As Liebowitz et al [10] suggested: 'One possible variant of a new mixed anxiety/depression category would be GAD plus a current affective disorder.…”

Transtornos depressivos em crianças com leucemia linfoide aguda e com insuficiência renal crônica terminal: estudo de série de casos

“…Em relação ao diagnóstico de transtorno distímico, no presente estudo os pacientes tiveram uma taxa de 15,4%, que está acima da encontrada na literatura para escolares saudáveis, na qual sua prevalência varia de 0,6% a 1,7% para crianças e de 1,6% a 8% para adolescentes 21,26 . No que diz respeito às doenças de base estudadas, não foi observada diferença em relação ao diagnóstico de episódio depressivo maior, mas, em relação ao transtorno distímico, sim.…”