ISSN 1302-6631
 

Original Research 


Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation

Salih Saygın Eker, Cengiz Akkaya, Şengül Cangür, Aslı Sarandöl, Ebru Öztepe Yavaşçi, Ülkü Sarıkavaklı, Selçuk Kırlı.

Abstract
Objective: The aim of this study was to determine the distribution and severity of depression symptoms, func-tional impairment and compare these variables between early- onset (EO) and late-onset (LO) dysthymic disorder patients. Methods: One hundred and ninety-two patients (174 women, 18-65 years of age) diagnosed with dys-thymic disorder (DD) according to DSM-IV were included. Patients with double depression, ongoing major depres-sion, axis I or II diagnosis and uncontrolled physical illness were excluded. Patients were evaluated using Hamil-ton Depression Rating Scale (HDRS) and Social Adaptation Self-evaluation Scale (SASS). The sample was divided into two groups depending on age at onset (early <21 or late ≥21). Results: There were 25 (13%) patients in EO and 167 (87%) were in LO group. Mean score of HDRS was higher in the EO (z=-2.03, p=0.042) whereas mean score of SASS was higher in the LO group (z=-2.98, p=0.003). EO patients were younger (p<0.001), had longer duration of DD (p<0.001), onset of DD was earlier (p<0.001), greater proportion of the EO group had a family history of history of affective disorder (p=0.009). The mean score of HDRS was conversely correlated with the mean score of SASS (r=-0.182, p=0.011) in the whole group. The mean score of HDRS was conversely cor-related with the mean score of SASS (r=-0.176, p=0.023) in the LO group, whereas no such correlation was found in the EO group. Individual HDRS items of ‘thoughts of suicide’ (p=0.009) and ‘work and activities’ (p=0.002) were more frequent in EO group. Conclusion: EO and LO patients differs on a number of variables, including age of onset, the severity and the duration of the illness, family history of mood disorder, lifetime history of major depressive episode and social adjustment. Since DD is a chronic disorder and has severe consequences DD patients, EO patients in particular, should be treated adequately and monitored regularly.

Key words: dysthymic disorder, functional impairment, early-onset dysthymia



Erken ve geç başlangıçlı distimik bozukluğun klinik özellikleri, belirti dağılımı ve sosyal uyum yönünden farklılıkları

Ozet
Amaç: Erken ve geç başlangıçlı distimik bozukluk (DB) hastalarında depresif belirtilerin şiddet ve dağılımları ile işlevselliğin değerlendirilmesi ve bu değişkenlerin iki grup arasında karşılaştırılmasıdır. Yöntem: DSM-IV’e göre DB tanısı konan 192 hasta (174 kadın, 18-65 yaş arası) çalışmaya alındı. Çifte depresyonlu, eksen I ve eksen II bozukluğu olan ve denetim altına alınamamış tıbbi hastalığı olan hastalar dışlandı. Hastalar Hamilton Depresyon Derecelendirme Ölçeği (HAM-D) ve Sosyal Uyum Kendini Değerlendirme Ölçeği (SUKDÖ) ile değerlendirildi. İstatistiksel değerlendirme için grup bozukluğun başlangıç yaşına ikiye ayrıldı (erken <21 yaş ya da geç ≥21 yaş). Bulgular: Erken başlangıçlı grupta 25 (%13) geç başlangıçlı grupta 167 (%87) hasta yer alıyordu. HAM-D ortala-ma değeri (z=-2.03, p=0.042) erken başlangıçlı grupta yüksekken, SUKDÖ ortalama değeri geç başlangıçlı grupta daha yüksekti (z=-2.98, p=0.003). Erken başlangıçlı grupta hastalar daha genç (p<0.001), bozukluğun süresi daha uzun (p<0.001) ve başlangıç yaşı daha erken (p<0.001), birinci derece akrabalarda duygudurum bozukluğu görülme oranı (p=0.009) daha fazlaydı. Tüm grup değerlendirildiğinde HAM-D ortalama değeri SUKDÖ ortalama değeri ile ters yönde ilişkili saptandı (r=-0.182, p=0.011). Erken başlangıçlı grupta yine HAM-D ortalama değeri SUKDÖ ortalama değeri ile ters yönde ilişkili iken (r=-0.176, p=0.023), geç başlangıçlı grupta böyle bir ilişki sap-tanmadı. HAM-D maddeleri tek tek incelendiğinde ‘özkıyım’ (p=0.009) ve ‘iş ve etkinlik’ (p=0.002) maddeleri erken başlangıçlı grupta daha sık olarak saptandı. Tartışma: Başta bozukluğun başlangıç yaşı, şiddeti ve süresi, birinci derece akrabalarda duygudurum bozukluğu öyküsünün varlığı, geçirilmiş depresif nöbetlerin varlığı ve sosyal işlevsellik alanlarında erken ve geç başlangıçlı DB farklılaşmaktadır. DB süreğen ve ciddi işlevsellik yitimi gibi önemli sonuçları olduğundan, bozukluğa ait özelliklerin sorgulanarak bozukluğun erken tanınması bozukluğun doğurabileceği olumsuz sonuçları hafifletebilir.

Anahtar Kelimeler: Distimi, işlevsellik kaybı, erken başlangıçlı distimi


 
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Pubmed Style

Eker SS, Akkaya C, Cangur S, Sarandol A, Yavasci EO, Sarikavakli U, Kirli S. [Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]. Anadolu Psikiyatri Derg. 2011; 12(1): 49-54. Turkish.


Web Style

Eker SS, Akkaya C, Cangur S, Sarandol A, Yavasci EO, Sarikavakli U, Kirli S. [Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]. http://www.anadolupsikiyatri.net/?mno=4698 [Access: October 22, 2018]. Turkish.


AMA (American Medical Association) Style

Eker SS, Akkaya C, Cangur S, Sarandol A, Yavasci EO, Sarikavakli U, Kirli S. [Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]. Anadolu Psikiyatri Derg. 2011; 12(1): 49-54. Turkish.



Vancouver/ICMJE Style

Eker SS, Akkaya C, Cangur S, Sarandol A, Yavasci EO, Sarikavakli U, Kirli S. [Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]. Anadolu Psikiyatri Derg. (2011), [cited October 22, 2018]; 12(1): 49-54. Turkish.



Harvard Style

Eker, S. S., Akkaya, C., Cangur, S., Sarandol, A., Yavasci, E. O., Sarikavakli, U. & Kirli, S. (2011) [Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]. Anadolu Psikiyatri Derg, 12 (1), 49-54. Turkish.



Turabian Style

Eker, Salih Saygin, Cengiz Akkaya, Sengul Cangur, Asli Sarandol, Ebru Oztepe Yavasci, Ulku Sarikavakli, and Selcuk Kirli. 2011. [Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]. Anatolian Journal of Psychiatry, 12 (1), 49-54. Turkish.



Chicago Style

Eker, Salih Saygin, Cengiz Akkaya, Sengul Cangur, Asli Sarandol, Ebru Oztepe Yavasci, Ulku Sarikavakli, and Selcuk Kirli. "[Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]." Anatolian Journal of Psychiatry 12 (2011), 49-54. Turkish.



MLA (The Modern Language Association) Style

Eker, Salih Saygin, Cengiz Akkaya, Sengul Cangur, Asli Sarandol, Ebru Oztepe Yavasci, Ulku Sarikavakli, and Selcuk Kirli. "[Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]." Anatolian Journal of Psychiatry 12.1 (2011), 49-54. Print.Turkish.



APA (American Psychological Association) Style

Eker, S. S., Akkaya, C., Cangur, S., Sarandol, A., Yavasci, E. O., Sarikavakli, U. & Kirli, S. (2011) [Early- versus late onset dysthymic disorder: clinical characteristics, symptom profile and social adaptation ]. Anatolian Journal of Psychiatry, 12 (1), 49-54. Turkish.





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