2013, Número 4
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Rev Mex Neuroci 2013; 14 (4)
La distimia como entidad nosológica. Algunas consideraciones clínicas, epidemiológicas, etiológicas y de utilidad diagnóstica
Gallardo-Moreno G, Jiménez-Maldonado M, González-Garrido A, Villaseñor-Cabrera T
Idioma: Español
Referencias bibliográficas: 65
Paginas: 215-222
Archivo PDF: 114.24 Kb.
RESUMEN
Siguiendo la definición establecida por el DSM-IV y acorde a un importante acúmulo de evidencia empírica, la distimia puede considerarse como un trastorno depresivo leve, pero crónico, que afecta hasta 3% de la población en cualquier comunidad. La distimia causa deterioro de la calidad de vida del paciente y se caracteriza por un estado de ánimo deprimido, que aunque resulta menos severo que en un cuadro depresivo mayor, impacta significativamente el funcionamiento cognitivo, la ejecución de tareas cotidianas, la integración social y la autoestima del paciente. La elevada comorbilidad de la distimia con otros desórdenes psiquiátricos y su pobre estabilidad clínica a través del tiempo, han determinado un intenso debate sobre la utilidad de preservar el diagnóstico actual de distimia como una entidad nosológica única, o pasar a considerar este estado, en el dominio del tiempo, como una etapa evolutiva más del trastorno depresivo mayor. Este artículo recolecta y discute aspectos relevantes de la distimia desde el punto de vista histórico, epidemiológico, etiológico y clínico, con el propósito principal de contribuir a una discusión más integral sobre el conocimiento que tenemos de esta entidad y la posible utilidad clínica de conservar tal diagnóstico o uno equivalente en el futuro.
REFERENCIAS (EN ESTE ARTÍCULO)
Akiskal HS. Dysthymia and cyclothymia in psychiatric practice a century after Kraepelin. J Affect Disord 2001; 62: 17-31.
Griffiths J, Ravindran AV, Merali Z, Anisman H. Dysthymia: a review of pharmacological and behavioral factors. Mol Psychiatry 2000; 5: 242-61.
Moch S. Dysthymia: more than minor depression. SA Pharmaceutical Journal 2011; 78: 38-43.
Ravindran A, Smith A, Cameron C, Bhatla R, Cameron I, Georges T, et al. Toward a functional neuroanatomy of dysthymia: A functional magnetic resonance imaging study. J Affect Disord 2009; 119: 9-15.
Hayden E, Klein D. Outcome of Dysthymic Disorder at 5-Year Follow-Up: The Effect of Familial Psychopathology, Early Adversity, Personality, Comorbidity and Chronic Stress. Am J Psychiatry 2001; 158: 1864-70.
Cuijpers P, Van Straten A, Schuurmans J, Van Oppen P, Hollon S, Andersson G. Psychoterapy for chronic major depression and dysthymia: A meta-analysis. Clin Psychol Rev 2010; 30: 51-62.
Vallejo-Ruiloba J, Leal-Cercós C. Tratado de Psiquiatría. Volumen II. España: Ars Médica; 2005.
Asociación Psiquiátrica Mexicana. Guía de la Asociación Psiquiátrica de América Latina para el tratamiento de las personas con depresión 2008.
Klein D, Schwartz J, Rose S, Leader J. Five-year course and outcome of dysthymic disorder: a prospective, naturalistic follow-up study. Am J Psychiatry 2000; 157: 931-9.
Markowitz JC, Skodol AE, Petkova E, Xie H, Cheng J, Hellerstein DJ, et al. Longitudinal comparison of depressive personality disorder and dysthymic disorder. Compr Psychiatry 2005; 46: 239-45.
Spanemberg L, Juruena M. Dysthymia: historical/nosological characteristics and its relationship with mayor depressive disorder. Rev Psiquatr Rio Gd Sul 2004; 26: 300-11.
Freeman HL. Historical and nosological aspects of dysthymia. Acta Psychiatr Scand 1994; 89(Suppl. 383): 7-11.
Lopez JJ, Frances A, Jones C. Dysthymic disorder: a comparison of DSM-IV and ICD-10 and issues in differential diagnosis. Acta Psychiatr Scand 1994; 89 (Suppl. 383): 12-8.
American Psychiatric Association. DSM-IV-TR Manual diagnóstico y Estadístico de los Trastornos Mentales Texto Revisado. México: Ed. Masson; 2002.
Walsh MA, Brown LH, Barrantes-Vidal N, Kwapil T. The expression of affective temperaments in daily life. J Affect Disord 2013; 145: 179-86.
Larraguibel M. Depresión y distimia en niños y adolescentes. Boletín especial. Sociedad de Psiquiatría y Neurología de la Infancia y la Adolescencia 2003; 1: 21-4.
Leader J, Klein D. Social adjustment in dysthymia, double depression and episodic major depression. J Affect Disord 1996; 3: 91-101.
Saddock B, Saddock V. Kaplan & Saddock Sinopsis de psiquiatría. 10a. Ed. USA: Lippincott, 2008.
Niculescu III A, Akiskal H. Proposed endophenotypes of dysthymia: evolutionary, clinical and pharmacogenomic considerations. Mol Psychiatry 2001; 6: 363-6.
Akiskal HS. Validating ‘hard’ and ‘soft’ phenotypes within the bipolar spectrum: continuity or discontinuity? J Affect Disord 2003; 73: 1-5.
Barzega G, Maina G, Venturello S, Bogetto F. Dysthymic disorder: clinical characteristics in relation to age at onset. J Affect Disord 2001; 66: 39-46.
Bellino S, Pátria L, Ziero S, Rocca G, Bogetto F. Clinical features of dysthymia and age: a clinical investigation. Psychiatry Res 2001; 103: 219-28.
Klein DN, Schatzberg AF, McCullough JP, Keller MB, Dowling F, Goodman D, et al. Early-versus late-onset dysthymic disorder: comparison in out-patients with superimposed major depressive episodes. J Affect Disord 1999; 52: 187-96.
Angst J. Dysthymia and personality. Eur Psychiatry 1998; 13: 188-97.
Sansone RA, Sansone LA. Early-versus late-onset dysthymia: a meaningful clinical distinction? Psychiatry (Edgemont) 2009; 6: 14-17.
Klein DN, Taylor EB, Dickstein S, Harding K. The early-late onset distinction in DSM-III-R dysthymia. J Affect Disord 1988; 14: 25-33.
Ravindran AV, Griffiths J, Merali Z, Anisman H. Primary dysthymia: a study of several psychosocial, endocrine and immune correlates. J Affect Disord 1996; 40: 73-84.
McCullough JP, Braith JA, Chapman, RC, Kasnetz MD, Carr KF, Cones JH, et al. Comparison of early and late onset dysthymia. J Nerv Ment Dis 1990; 178: 577-81.
Klein DN, Santiago N. Dysthymia and chronic depression: introduction, classification, risk factors, and course. Journal of Clinical Psychology 2003, 59: 807-16.
Szadoczky E, Fazekas I, Rihmer Z, Arato M. The role of psychosocial and biological variables in separating chronic and non-chronic major depression and early-late-onset dysthymia. J Affect Disord 1994; 32: 1-11.
Devanand DP, Adorno E, Cheng J, Burt T, Pelton GH, Roose SP, et al. Late onset dysthymic disorder and major depression differ from early onset dysthymic disorder and major depression in elderly outpatients. J Affect Disord 2004; 78: 259-67.
Barbui C, Motterlini N, Garattini L. Health status, resource consumption, and costs of dysthymia. A multi-center two-year longitudinal study. J Affect Disord 2006; 90: 181-6.
Mejora y ampliación de la atención de los trastornos mentales, neurológicos y por abuso de sustancias. Versión provisional en español. Organización Mundial de la Salud, 2008. (Obtenido el 1 de Septiembre de 2011 en: http://www.who.int/mental_health/mhgap/ mhgap_spanish.pdf).
Airaksinen E, Larsson M, Lundberg I, Forsell Y. Cognitive functions in depressive disorders: evidence from a population-based study. Psychol Med 2004; 3: 83-91.
Baena A, Sandoval M, Urbina C, Helen N, Villaseñor S. Los trastornos del estado de ánimo. Revista Digital Universitaria 2005; 6: 1-14.
Informática Médica, Archivo Clínico y Bioestadística. Informe anual 2011. Hospital Civil de Guadalajara Fray Antonio Alcalde.
Gureje O. Dysthymia in a cross-cultural perspective. Curr Opin Psychiatry 2010; 24: 67-71.
Aragonés E, Gutiérrez M, Pino M, Lucena C, Cervera J, Garreta I. Prevalencia y características de la depresión mayor y la distimia en atención primaria. Aten Primaria 2001; 27: 623-8.
Hellerstein D, Agosti V, Bosi M, Black S. Impairment in psychosocial functioning associated with dysthymic disorder in the NESARC study. J Affect Disord 2010; 127: 84-8.
Yee C, Miller G. A dual-task analysis of resource allocation in dysthymia and anhedonia. J Abnor Psychol 1994; 103: 625-36.
Garcia-Toro M, Talavera J, Gonzalez E, Tejada P, Blanco C, Gonzalez A, et al. Audioverbal cognitive dysfunction in depression. Factors involved. Prog Neuropsychopharmacol Biol Psychiatry 2003; 27: 37-42.
Sadek N, Nemeroff C. Actualización en neurobiología de la depresión. (Carina Riciardi, trad.). Rev Psiquiatr Uruguay 2000; 64: 462-85.
Saletu-Zyhlarz GM, Abu-Bakr MH, Anderer P, Semler B, Decker K, Parapatics S, et al. Insomnia related to dysthymia: polisomnographic and psychometric comparison with normal controls and acute therapeutic trials with trazodone. Neuropsychobiology 2001; 44: 139-49.
Aydemir Ö, Deveci A, Taskin O, Taneli F, Esen-Danaci A. Serum brainderived neurotrophic factor level in dysthymia: A comparative study with major depressive disorder. Prog Neuro-Psychopharmacol Biol Psychiatry 2007; 31: 1023-6.
Ishizaki J, Mimura M. Dysthymia and apathy: Diagnosis and treatment. Hindawi Publishing Corporation. Depression Research and Treatment 2011; Open Acces doi:10.1155/2011/893905.
Diener C, Kuehner C, Brusniak W, Struve M, Flor H. Effects of stressor controllability on psychophysiological, cognitive and behavioural responses in patients with major depression and dysthymia. Psychol Med 2009; 39: 77-86.
Arriaga F, Cavaglia F, Matospires A, Lara E, Paiva T. EEG sleep characteristics in dysthymia and major depressive disorder. Neuropsychobiology 1995; 32: 128-31.
Klein DN, Riso LP, Donaldson SK, Schwartz JE, Anderson RL, Ouimette PL, et al. Family study of early-onset dysthymia. Mood and personality disorders in relatives of outpatients with dysthymia and episodic major depression and normal controls. Arch Gen Psychiatry 1995; 52: 487-96.
Guadarrama L, Escobar A, Zhang L. Bases neuroquímicas y neuroanatómicas de la depresión. Rev Fac Med UNAM 2006; 49(2).
Krishnan V, Nestler E. The molecular neurobiology of depression. Nature 2008; 45: 894-902.
Kronfol Z, Remick D. Cytokines and the brain: Implications for clinical psychiatry. Am Psychiatry 2000; 157: 683-94.
Fertuzinhos SMM, Oliveira JRM, Nishimura AL, Pontual D, Carvalho DR, Sougey EB, et al. Analysis of IL-1α, IL-1β, and IL-RA Polymorphisms in Dysthymia. J Mol Neurosci 2004; 22: 251-5.
Symonds C, Anderson IM. Unipolar depression and dysthymia. Medicine 2012; 40: 591-5.
Schlatter J, Ortuño F, Cervera-Enguix S. Monocytic parameters in patients with dysthymia versus major depression. J Affect Disord 2004; 78: 243-7.
Yoshimura R, Umene-Nakako W, Hoshuyama T, Ikenouchi-Sugita A, Hori H, Katsuki A, et al. Plasma levels of brain-derived neurotrophic factor and inteleukin-6 in patients with dysthymic disorder: comparison with age- and sex-matched major depressed patients and healthy controls. Hum Psychopharmacol 2010; 25: 566-9.
Sen S, Duman R, Sanacora G. Serum Brain-Derived Neurotrophic Factor, Depression, and Antidepressant Medications: Meta-Analyses and Implications. Biol Psychiatry 2008; 64: 527-32.
Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, et al. Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 2003; 301: 386-9.
Werner N, Meindl T, Materne J, Engel R, Huber D, Riedel M, et al. Functional MRI study of memory-related brain regions in patients with depressive disorder. J Affect Disord 2009; 119: 124-31.
Davidson R, Irwin W. The functional neuroanatomy of emotion and affective style. Trends in Cogn Sci 1999; 3: 11-21.
Fitzgerald PB, Oxley TJ, Laird AR, Kulkarni J, Egan GF, Daskalakis ZJ. An analysis of functional neuroimaging studies of dorsolateral prefrontal cortical activity in depression. Psychiatry Res 2006; 148: 33-45.
Maeda F, Keenan J, Pascual-Leone A. Interhemispheric asymmetry of motor cortical excitability in major depression as measured by transcranial magnetic stimulation. BJPsych 2000; 177: 169-173.
Mineka S, Watson D, Clark LA. Comorbidity of anxiety and unipolar mood disorders. Annu Rev Psychol 1998; 49: 377-412
Akiskal HS. Dysthymic disorder: psychopathology of proposed chronic depressive subtypes. Am J Psychiatry 1983; 140: 11-20.
Ryder AG, Bagby RM, Schuller DR. The overlap of depressive personality disorder and dysthymia: a categorical problem with a dimensional solution. Harvard Rev Psychiatry 2002; 10: 337-52
Murphy JA, Byrne GJ. Prevalence and correlates of the proposed DSM- 5 diagnosis of Chronic Depressive Disorder. J Affect Disord 2012; 139: 172-80.