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The undertreatment of dysthymia.

Publication ,  Journal Article
Shelton, RC; Davidson, J; Yonkers, KA; Koran, L; Thase, ME; Pearlstein, T; Halbreich, U
Published in: J Clin Psychiatry
February 1997

BACKGROUND: Dysthymia is a chronic depressive condition that is quite prevalent. This condition can exact a significant toll on the general health and quality of life in the affected individual. Despite the frequency and consequences of dysthymia, however, the condition is often not diagnosed or treated. We present data on prior treatment from 410 patients with DSM-III-R dysthymia, primary type, early onset without concurrent major depression. METHOD: Axis I and II diagnoses were made by using the Structured Clinical Interviews for DSM-III-R, Patient Version (SCID-P) and SCID II for Personality Disorders. The Hamilton Rating Scale for Depression and the Clinical Global Impressions scale were also completed. Prior treatment was assessed, with special attention paid to previous antidepressant drug therapy and psychotherapy. RESULTS: Although the mean duration of dysthymia was about 30 years and almost half of the patients had previous episodes of major depression, only 41.3% had been treated with antidepressants and 56.1% with psychotherapy. A past history of major depression increased the frequency of prior antidepressant pharmacotherapy (45.7%) and psychotherapy (59.4%) compared with no history of major depression (36.8% and 40.9%, respectively). Comorbid personality disorder increased the likelihood of prior psychotherapy (70.7% vs. 49.6%) while having no effect on past pharmacotherapy. A history of substance abuse did not affect the history of antidepressant or psychotherapy treatment. In this study, dysthymia and psychosocial outcomes improved with sertraline and imipramine treatment. CONCLUSION: Dysthymic patients in this sample were significantly undertreated. Newer antidepressant agents may alter the potential for pharmacotherapy interventions in this vulnerable population.

Duke Scholars

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Published In

J Clin Psychiatry

DOI

ISSN

0160-6689

Publication Date

February 1997

Volume

58

Issue

2

Start / End Page

59 / 65

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Single-Blind Method
  • Sertraline
  • Psychotherapy
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Prevalence
  • Placebos
  • Personality Disorders
  • Middle Aged
 

Citation

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Shelton, R. C., Davidson, J., Yonkers, K. A., Koran, L., Thase, M. E., Pearlstein, T., & Halbreich, U. (1997). The undertreatment of dysthymia. J Clin Psychiatry, 58(2), 59–65. https://doi.org/10.4088/jcp.v58n0202
Shelton, R. C., J. Davidson, K. A. Yonkers, L. Koran, M. E. Thase, T. Pearlstein, and U. Halbreich. “The undertreatment of dysthymia.J Clin Psychiatry 58, no. 2 (February 1997): 59–65. https://doi.org/10.4088/jcp.v58n0202.
Shelton RC, Davidson J, Yonkers KA, Koran L, Thase ME, Pearlstein T, et al. The undertreatment of dysthymia. J Clin Psychiatry. 1997 Feb;58(2):59–65.
Shelton, R. C., et al. “The undertreatment of dysthymia.J Clin Psychiatry, vol. 58, no. 2, Feb. 1997, pp. 59–65. Pubmed, doi:10.4088/jcp.v58n0202.
Shelton RC, Davidson J, Yonkers KA, Koran L, Thase ME, Pearlstein T, Halbreich U. The undertreatment of dysthymia. J Clin Psychiatry. 1997 Feb;58(2):59–65.

Published In

J Clin Psychiatry

DOI

ISSN

0160-6689

Publication Date

February 1997

Volume

58

Issue

2

Start / End Page

59 / 65

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Single-Blind Method
  • Sertraline
  • Psychotherapy
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Prevalence
  • Placebos
  • Personality Disorders
  • Middle Aged