Cyclothymia F34.0 - ICD10 Description, World Health Organization
Cyclothymic Disorder - Diagnostic Criteria, American Psychiatric AssociationThis disorder, for at least 2 years, has numerous periods with mild elation, and numerous periods with mild depression. The elation never becomes severe enough to meet the diagnostic criteria for a manic, mixed, or hypomanic episodes, and the depression never becomes severe enough to meet the diagnostic criteria for a major depressive episode. The duration of this disorder only needs to be 1 year in children and adolescents. To be diagnosed, this disorder must cause significant impairment in an individual's life. This disorder is frequently found in the relatives of patients with bipolar disorder. Some patients with cyclothymic disorder eventually develop bipolar disorder.
Effective TherapiesThere are only a few research studies on the effectiveness of treatment for this disorder. This research has shown that medication (mood-stabilizers used in combinatiion with antidepressants) is highly effective. In addition, cognitive behavioral therapy (CBT), and well-being therapy have been shown to be effective. Informing patients and their families about this illness significantly improves patient compliance and family cooperation.
Ineffective TherapiesVitamins, dietary supplements, and acupuncture are all ineffective for mood disorders.
PrevalenceLifetime prevalence for this disorder in the general population is 0.4% to 1%. This disorder is more common in women and men.
CourseThis disorder usually has an insidious onset in adolescence or early adult life. It often develops with prolonged periods of cyclical, often unpredictable mood changes. This disorder usually has a chronic course, and has a 15%-50% risk that the person will eventually develop bipolar I or II disorder.
Familial PatternFirst-degree biological relatives of individuals with cyclothymic disorder have elevated rates of bipolar I or II disorder, major depressive disorder, and substance-related disorders compared with the general population. Cyclothymic disorder is more common in the first-degree biological relatives of individuals with bipolar I disorder.
ComplicationsBy definition, there must clinically significant distress or impairment in social, occupational, or other important functioning as result of this mood disturbance.
ComorbidityThis disorder is associated with an increased risk of having substance-related disorders, sleep disorders and bipolar I or II disorder. Children with this disorder have an increased risk of having attention-deficit/hyperactivity disorder.
Associated Laboratory FindingsNo laboratory test has been found to be diagnostic of this disorder.
TreatmentThe most important first step in the treatment of this disorder is to prevent alcohol or illicit drug abuse. Medication often is ineffective when the individual is still abusing alcohol or illicit drugs.
There is little research on the treatment of cyclothymic disorder. Generally, research is showing that the medications that are effective in treating bipolar I disorder are also effective in cyclothymic disorder.
Mood stabilizers (e.g., lithium, carbamazepine and valproate) in combination with antidepressant medication (buproprion, SSRI or MAOI antidepressant medication) has been shown to be effective in the treatment of this disorder. Thyroid augmentation of antidepressant medication can be helpful.
Cognitive behavioral therapy (CBT), and well-being therapy have been shown to be effective. Psychoeducation (teaching patients and their families about this illness) significantly improves patient compliance and family cooperation.
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