Dysthymia. The importance of an early diagnosis and an efficient treatment

2016 
Introduction Dysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. It is important to distinguish it from other types of depression, as early as possible. The therapeutic management of dysthymia is similar to the one used in major depressive disorder. Objectives We report the case of a female patient aged 45, diagnosed with depressive disorder not otherwise specified since she was 20. Her psychopathological progress has gradually become aggravated, having now longer periods of depressive mood and an important tendency towards isolation. Methodology The patient is admitted to the Psychiatric Day Hospital presenting with important depressive symptoms. After various antidepressants were withdrawn, lithium salts were introduced. It is then that the patient starts improving her mood. Results – Dysthymia (F34.1). – Mixed and other personality disorders (F61.0). Conclusions In spite of having an appropriate pharmacological, unfortunately, antidepressants improve dysthymia just in 50–70% of patients. Antidepressants resistant dysthymia cases have been studied. In those cases, it has been necessary to add lithium or thyroxine. This confirms that, when it comes to this disorder, there are many neurochemical mechanisms involved, given the positive response to the combination of drugs, notwithstanding the severity of the adverse effects.
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