Jen is a 31-year-old female who presents for care complaining of a depressed mood; dysthymic disorder

Answer:

Jen is a 31-year-old female who presents for care complaining of a depressed mood. During the interview, it becomes apparent that she has a long history of depressive symptoms. Her depression is ongoing, chronic and recurrent, but it is minor or subclinical in severity. It does not significantly impair her functioning; however, it is apparent that she does experience ongoing episodes of mild disruption in her life.

Core Concept: Dysthymia refers to sub-affective or subclinical depressive disorder with all of the following except…

Dysthymia is: A) sub-affective or subclinical depressive disorder.

The term dysthymia or dysthymic disorder is used to refer to a milder but chronic sub-affective or subclinical depressive syndrome. This can be seen together with other affective, anxiety, and personality disorders. The symptoms that are required to come up with this diagnosis are at least two years of depressed mood for most days for most of the day, with additional symptoms such as poor appetite, weight changes and low energy levels. Jen is a 31-year-old female who presents for care complaining of a depressed mood. dysthymic disorder

In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV), dysthymic disorder is defined as a chronic, low-grade depressive illness with a duration of at least two years.  Dysthymia is characterized by the presence of two or more of the following symptoms: poor appetite or overeating, insomnia or excessive sleep, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness.  These symptoms must cause clinically significant distress and impairment in social, occupational, educational, or other important areas of functioning.

Jen’s depressive episodes have been a significant problem for her since age 15. The first time, a relative noted that she came home from school in a depressed mood, with teary eyes, slumped shoulders and a negative attitude. The second time, Jen was referred to the school nurse because she had been crying at lunchtime and was exhibiting changes in personal hygiene and appetite. Several months later, Jen was withdrawn from high school because of low grades. She gave birth to her first child at 17 years of age and separated from her husband shortly thereafter. Her son lives with his paternal grandmother. Jen received psychiatric treatment each year while living in an abusive relationship with a new partner who physically assaulted her and provided inadequate support for the care of their two young children. Jen is a 31-year-old female who presents for care complaining of a depressed mood dysthymic disorder

Dysthymia is a type of Low-grade or sub-syndromal depression and it is characterized by feelings of chronic sadness and/or unease in a person who has been experiencing symptoms for at least 2 years. It is also characterized by symptoms that are less severe and less disabling than those associated with major depressive disorder, making it difficult to diagnose. Compared to other types of mood disorders, dysthymia itself has relatively mild symptoms such as low energy, social withdrawal, constant negative thinking, irritability, depressed mood, and poor concentration. Only Dysthymia is characterized by these unique symptoms. dysthymic disorder

A. A continuous, chronic, and mild depression throughout adulthood with minimal symptoms that slightly interfere the individual’s daily activities (Meyer, 2012). The patient will tend to exhibit emotional and social withdrawal. Although she may have periods of clinical depression interspersed with periods of normality where she feels minimally depressed, it is not uncommon for a person with dysthymia to feel chronically depressed and somewhat sad. The DSM-IV-TR criteria require that a person must have chronic or recurrent symptoms of depression along with at least two of the following symptoms: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or indecisiveness (American Psychiatric Association, 2000). dysthymic disorder

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Question:

Jen is a 31-year-old female who presents for care complaining of depressed mood. During the interview, it becomes apparent that she has a long history of depressive symptoms, as well as a long history of being socially isolated and feeling generally inadequate. When considering a diagnosis of dysthymia, the PMHNP considers that the core concept of dysthymia refers to sub-affective or subclinical depressive disorder with all of the following except: dysthymic disorder