Treatment of Primary Dysthymia With Group Cognitive Therapy and Pharmacotherapy: Clinical Symptoms and Functional Impairments

Ravindran, Arun; Anisman, Hymie; Merali, Zul; Charbonneau, Y.; Telner, John; Bialik, Robert J.; Wiens, Andrew; Ellis, Jack; Griffiths, Jenna

doi:10.1176/ajp.156.10.1608

Cited by 120 publications

(89 citation statements)

References 67 publications

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“…[19][20][21] As such, the lack of controlled studies comparing the relative efficacy of psychotherapy and pharmacotherapy (either alone or in combination) is surprising. It was recently reported, however, that in the short-run, pharmacotherapy (using a selective serotonin reuptake inhibitor) was more efficacious than group cognitive behavior therapy (CBT) in alleviating symptoms of dysthymia, 22 although CBT attenuated several functional aspects of the illness. Using a somewhat more protracted regimen (16 weeks), CBT was effective in a study involving a small number of dysthymic subjects.…”

Section: Dysthymia: Clinical and Epidemiological Featuresmentioning

confidence: 99%

“…Moreover, it has been suggested that optimal drug effects would be obtained when administered primarily to patients with subaffective, rather than character spectrum disorder. 4 In fact, studies which employed rigorous diagnostic criteria, established the efficacy of tricyclic agents, such as imipramine and desipramine, [131][132][133][134][135][136][137] MAOIs, 136,138,139 the reversible monoamine oxidase inhibitor, moclobemide, 114,137,[140][141][142][143] SSRIs, such as fluoxetine and sertraline, 22,23,111,132,134,[144][145][146] as well as other agents, such Molecular Psychiatry as the 5HT 2 antagonist, ritanserin, 147,148 the selective norepinephrine reuptake inhibitor, reboxetine, 149 and the serotonin/norepinephrine reuptake inhibitor (SNRI), venlafaxine 150,151 (Table 1). The use of well tolerated compounds, including moclobemide and sertraline, may be effective in the long-term management of dysthymia.…”

Section: Pharmacological Contributions To the Analysis Of Dysthymiamentioning

confidence: 99%

“…165 As indicated earlier, we observed in a double-blind placebo-controlled study, that sertraline was generally more effective than group CBT in treating the symptoms of dysthymia, as measured by the Hamilton Depression Scale. 22 Of course, these data need to be considered as highly provisional, since the trial was short-term (12 weeks), and the CBT consisted of group rather than individual treatment. It is possible that individual CBT, or a program designed specifically for dysthymia may be more conducive to the treatment of the disorder.…”

Section: Pharmacological Contributions To the Analysis Of Dysthymiamentioning

confidence: 99%

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Dysthymia: a review of pharmacological and behavioral factors

et al. 2000

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Although dysthymia, a chronic, low-grade form of depression, has a morbidity rate as high as that of major depression, and increases the risk for major depressive disorder, limited information is available concerning the etiology of this illness. In the present report we review literature concerning the biological and characterological features of dysthymia, the effectiveness of antidepressant treatments, the influence of stressors in the precipitation and maintenance of the disorder, and both quality of life and psychosocial correlates of the illness. We also provisionally suggest that dysthymia may stem from disturbances of neuroendocrine and neurotransmitter functioning (eg, corticotropin releasing hormone and arginine vasopressin within the hypothalamus, or alternatively monoamine variations within several extrahypothalamic sites), and may also involve cytokine activation. The central disturbances may reflect phenotypic variations of neuroendocrine processes or sensitization of such mechanisms. It is suggested that chronic stressor experiences or stressors encountered early in life lead to the phenotypic neurochemical alterations, which then favor the development of the dysthymic state. Owing to the persistence of the neurochemical disturbances, vulnerability to double depression is increased, and in this instance treatment with antidepressants may attenuate the symptoms of major depression but not those of the basal dysthymic state. Moreover, the residual features of depression following treatment may be indicative of underlying neurochemical disturbances, and may also serve to increase the probability of illness recurrence or relapse. Molecular Psychiatry (2000) 5, 242-261.

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Section: Dysthymia: Clinical and Epidemiological Featuresmentioning

confidence: 99%

Section: Pharmacological Contributions To the Analysis Of Dysthymiamentioning

confidence: 99%

Section: Pharmacological Contributions To the Analysis Of Dysthymiamentioning

confidence: 99%

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Dysthymia: a review of pharmacological and behavioral factors

et al. 2000

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“…Estudos mostram que 50 a 60% dos pacientes com distimia respondem ao tratamento com antidepressivos 61,62 . Os inibidores da monoamino-oxidase (IMAO), os antidepressivos tricíclicos (ADT) e ISRS são eficazes no tratamento da distimia 40,61,63,64 .…”

Section: Comorbidade Com O Transtorno Depressivo Maiorunclassified

“…Os inibidores da monoamino-oxidase (IMAO), os antidepressivos tricíclicos (ADT) e ISRS são eficazes no tratamento da distimia 40,61,63,64 . Manipulações e reposições hormonais ainda carecem de estudos 65,66 .…”

Section: Comorbidade Com O Transtorno Depressivo Maiorunclassified

Distimia: características históricas e nosológicas e sua relação com transtorno depressivo maior

Spanemberg

Juruena

2004

Rev. psiquiatr. Rio Gd. Sul

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Transtorno distímico é uma forma crônica e incapacitante de depressão, ocorrendo em uma parcela substancial da população (3 a 6%) e aumentando os riscos de transtorno depressivo maior. Ela é associada a consideráveis incapacitações e elevada comorbidade. O status nosológico da distimia tem despertado consideráveis controvérsias ao longo das décadas passadas, sendo que algumas investigações a consideraram como um transtorno do humor e outras como um transtorno de personalidade. Classificada na nosografia atual entre os transtornos de humor, a distimia é hoje uma entidade tratável e que precisa receber maior atenção em virtude de sua morbidade. Este artigo revisa os principais aspectos históricos da distimia, suas características nosológicas, subtipos e sua relação com transtorno depressivo maior. Ao final, concluímos que novos estudos são necessários para a validação do conceito de distimia e do espectro de depressões crônicas, para uma melhor compreensão etiológica e para uma terapêutica baseada em evidências.

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Combined Pharmacotherapy and Psychological Treatment for Depression

Pampallona¹,

Bollini²,

Tibaldi³

et al. 2004

Arch Gen Psychiatry

453

241

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Psychological treatment combined with antidepressant therapy is associated with a higher improvement rate than drug treatment alone. In longer therapies, the addition of psychotherapy helps to keep patients in treatment. Further studies are needed to investigate whether the improvement in response attributable to the combination of drug treatment and psychotherapy can be achieved by a combination of pharmacotherapy and a compliance-enhancing intervention.

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Treatment of Primary Dysthymia With Group Cognitive Therapy and Pharmacotherapy: Clinical Symptoms and Functional Impairments

Cited by 120 publications

References 67 publications

Dysthymia: a review of pharmacological and behavioral factors

Dysthymia: a review of pharmacological and behavioral factors

Distimia: características históricas e nosológicas e sua relação com transtorno depressivo maior

Combined Pharmacotherapy and Psychological Treatment for Depression

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