Persistent or dystimia depressive disorder
Introduction
Dystimia is a chronic affective disorder that is associated with inappropriate strategies for adaptation to stressful situations, stress sensitivity, increased risk of hospital admission, low productivity at work, comorbidity with other psychiatric disorders and presence of other diseases. Living with the burden of dysthytimia or persistent depressive disorder leaves those affected and hopeless during most of their lives. And this prolonged and recurring depressive disorder has been little studied.
Developing
The term dystimia originated in ancient Greece and means bad mood. In the hypocratic school it was considered part of the broader concept of melancholy, which derived from the black bile poisoning, one of the four primary moods described by Hippocrates. Then, the concept of · dystimia was introduced again in Germany at the beginning of the 19th century to describe the depressions that have a chronic course. In 1863, Karl Kudwig Kahlbaum used the term dysthymia for forms of melancholy that presented only one phase and in a attenuated way, since during that time all humor disorders were included in what was considered as manic-depressive psychosis. In fact, this denomination has been used until not too long ago.
In 1921, Eil Kraepelin described the relationship between maniac-depressive disorder and depressive temperament. He proposed that the second was just an attenuated form, but that belonged to the same pathological constellation. Although Kraepelin did not use the term dystimia, he considered a depressive provision as one of the constitutive bases of affective episodes.
In 1923, Kurt Schneider described the distlic or depressive psychopathy in relation to a combination of neonatal and hereditary factors, as well as early environmental variables, without specifically considering it as an affective disorder. Thus, he described a type of depression whose existence implied only suffering.
For Schneider, the individuals who suffered this condition were characterized by being unable to have fun, being sad, being prone to guilt, having a lack of trust and low self – esteem, feeling sad, slow, not assertive, shy and sensitive. Somehow, Schneider considered this type of depressive psychopathy within personality disorders.
conclusion
It was not until the 50s that, thanks to the influence of Schneider, the diagnostic and statistical manual of mental disorders II (DSM-II) and the international classification of diseases in its ninth version (CIE-9) propose the idea that chronic depression is equivalent to character neurosis. Thus, the term neurotic depression appears in the DSM-II and depressive neurosis in the CIE-9, being considered in both manuals as non-chronic episodes.
Afterwards, the DSM-III changed the chronic depression reference to the distinimic disorder, thus replacing the neurotic depression of the DSM-II and was included in the affective disorders chapter. Subsequently, in the early starting and late starting classification classification, late. Then, in the DSM-IV, the criteria considered to dysthymia as a chronic unipolar affective disorder, which can start early or late and whose symptomatology is less intense than that observed in a major depressive episode.
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