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'''Cyclothymia''' is a [[mood disorder]]. This disorder is a milder form of [[bipolar II disorder]] consisting of recurrent mood disturbances between [[hypomania]] and [[dysthymic]] mood. A single episode of hypomania is sufficient to diagnose cyclothymic disorder; however, most individuals also have [[dysthymic]] periods. The diagnosis of cyclothymic disorder is never made when there is a history of mania or major depressive episode or mixed episode (as told in "Blueprints in Psychiatry" - "mood disorders").
'''Cyclothymia''' is a chronic bipolar disorder that consists of short periods of mild [[clinical depression|depression]] alternating with short periods of [[hypomania]]. It is considered to be a [[chronic (medicine)|chronic]], low level form of [[bipolar disorder]]. The onset of each phase is separated by short periods of normal mood.
 
Cyclothymic disorder is a recurrent, chronic, mild form of bipolar disorder in which mood typically oscillates between hypomania and [[dysthymia]]. It is not diagnosed if a person has had either a manic episode or a major depressive episode.
 
   
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The lifetime prevalence of cyclothymic disorder is 0.4-1%. The rate appears equal in men or women, though women more often seek treatment.
==History and Mental Status Examination==
 
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== Diagnostic Criteria ==
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=== Diagnostic Criteria ([[DSM-IV-TR]]) ===
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* During the first two years of the disorder, the patient has not fulfilled enough criteria to qualify as having either [[bipolar disorder]] or [[major depressive disorder]].
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* Symptoms are present for at least two years: periods of hypomanic symptoms and periods of low mood that do not fulfill the criteria for [[major depressive disorder]].
  +
* The longest period the patient has been free of symptoms is two months.
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* The disorder cannot be better explained as [[schizoaffective disorder]], and it is not superimposed on [[schizophrenia]], [[schizophreniform disorder]], [[delusional disorder]] or psychotic disorder not otherwise specified.
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* Symptoms are not directly caused by a general medical condition or the use of any substances such as prescription medicines.
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* The symptoms do not cause the patient clinically significant distress or impair work, social or personal functioning.
  +
  +
* A person with this disorder may experience euphoric highs, boosts of energy and require less sleep in one phase, followed by a severe mood swings into a depressive state coupled with negativity & sadness for no particular reason.
  +
* These mood swings are not as severe as [[bipolar I disorder]] or [[bipolar II disorder]].
  +
* Cyclothymia is to [[bipolar disorder]] as Dysthymia (a mild form of clinical depression) is to [[major depressive disorder]].
  +
  +
=== Diagnostic Criteria ([[ICD-10]])===
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A persistent instability mood, involving numerous periods of mild depression and mild elation. This instability usually develops early in adult life and pursues a chronic course, although at times the mood may be normal and stable for months at a time. The mood swings are usually perceived by the individual as being unrelated to life events. The diagnosis is difficult to establish without a prolonged period of observation or an unusually good account of the individual's past behaviour. Because the mood swings are relatively mild and the periods of mood elevation may be enjoyable, cyclothymia frequently fails to come to medical attention. In some cases this may be because the mood change, although present, is less prominent than cyclical changes in activity, self-confidence, sociability, or appetitive behaviour. If required, age of onset may be specified as early (in late teenage or the twenties) or later.
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The essential feature is a persistent instability of mood, involving numerous periods of mild depression and mild elation, none of which has been sufficiently severe or prolonged to fulfill the criteria for bipolar disorder or recurrent depressive disorder. This implies that individual episodes of mood swings do not fulfill the criteria for any of the categories described under [[manic episode]] or [[major depressive episode]].
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== Differential Diagnosis ==
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This disorder is common in the relatives of patients with bipolar disorder and some individuals with cyclothymia eventually develop bipolar disorder themselves. It may persist throughout adult life, cease temporarily or permanently, or develop into more severe mood swings meeting the criteria for bipolar disorder or recurrent depressive disorder in rare cases.
   
 
== Causes ==
 
== Causes ==
Cyclothymia appears to have a significant genetic contribution, which has been shown by a range of twin studies involving dizygotic and monozygotic twins.
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Cyclothymia appears to have a genetic contribution, which has been shown by a range of twin studies involving dizygotic (fraternal) and monozygotic (identical) [[twins]].{{Fact|date=September 2007}}
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Brain changes in cyclothymia include a variety of changes in the receptor mechanisms.
 
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Psychosocial factors have also been implicated, for example stressful life events or living conditions, and interpersonal difficulties. In addition, some unsupported theories posit that the hypomanic episodes have meaning in the context of a person seeking to achieve goals or to avoid depression.{{Fact|date=September 2007}}
   
 
== Treatment ==
 
== Treatment ==
Treatment for cyclothymia can range from a variety of cognitive and behavioural techniques to the administration of mood stabilizing drugs.
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Treatment for cyclothymia can include a variety of [[cognitive behavioral therapy]] techniques. Additionally, [[mood stabilizers]], such as [[lithium]] and medications for [[anxiety]] and mood stabilization such as [[benzodiazepines]], are often prescribed in low doses to treat Cyclothymia.
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Mood stabilisers are frequently prescribed to treat cyclothymia, although sufferers may choose to remain untreated, or to undergo supportive psychotherapy alone. Mood stabilizers such as anticonvulsants (especially Lamictal and Depakote) as well as lithium are commonly prescribed and have been shown to help a substantial number of people.
 
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== See also ==
 
== See also ==
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* [[Cyclothymic personality]]
 
* [[Dysthymia]]
 
* [[Dysthymia]]
 
* [[Euthymia]]
 
* [[Euthymia]]
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* [[Emotional reactivity]]
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* [[Emotionally unstable personality disorder]]
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* [[Labile affect]]
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* [[Labile personality]]
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* [[Manic depression]]
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* [[Neuroticism]]
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* [[Ultradian|Ultradian Bipolar Disorder]]
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==References==
   
 
== External links ==
 
== External links ==
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*[http://www.mental-health-matters.com/articles/article.php?artID=56 What Is Cyclothymia?]
 
*[http://www.mental-health-matters.com/articles/article.php?artID=56 What Is Cyclothymia?]
 
*[http://www.mental-health-matters.com/disorders/dis_details.php?disID=27 Mental Health Matters: Cyclothymia]
 
*[http://www.mental-health-matters.com/disorders/dis_details.php?disID=27 Mental Health Matters: Cyclothymia]
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*[http://www.allaboutdepression.com/cyclothymia/about.shtml Cyclothymia Workbook]
   
[[Category:Mood disorders]]
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[[Category:Bipolar disorder]]
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[[Category:Affective disorders]]
   
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[[nl:Cyclothyme stoornis]]
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{{enWP|Cycothymia}}
 
{{enWP|Cycothymia}}

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Cyclothymia is a mood disorder. This disorder is a milder form of bipolar II disorder consisting of recurrent mood disturbances between hypomania and dysthymic mood. A single episode of hypomania is sufficient to diagnose cyclothymic disorder; however, most individuals also have dysthymic periods. The diagnosis of cyclothymic disorder is never made when there is a history of mania or major depressive episode or mixed episode (as told in "Blueprints in Psychiatry" - "mood disorders").

The lifetime prevalence of cyclothymic disorder is 0.4-1%. The rate appears equal in men or women, though women more often seek treatment.

Diagnostic Criteria

Diagnostic Criteria (DSM-IV-TR)

  • During the first two years of the disorder, the patient has not fulfilled enough criteria to qualify as having either bipolar disorder or major depressive disorder.
  • Symptoms are present for at least two years: periods of hypomanic symptoms and periods of low mood that do not fulfill the criteria for major depressive disorder.
  • The longest period the patient has been free of symptoms is two months.
  • The disorder cannot be better explained as schizoaffective disorder, and it is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder or psychotic disorder not otherwise specified.
  • Symptoms are not directly caused by a general medical condition or the use of any substances such as prescription medicines.
  • The symptoms do not cause the patient clinically significant distress or impair work, social or personal functioning.
  • A person with this disorder may experience euphoric highs, boosts of energy and require less sleep in one phase, followed by a severe mood swings into a depressive state coupled with negativity & sadness for no particular reason.
  • These mood swings are not as severe as bipolar I disorder or bipolar II disorder.
  • Cyclothymia is to bipolar disorder as Dysthymia (a mild form of clinical depression) is to major depressive disorder.

Diagnostic Criteria (ICD-10)

A persistent instability mood, involving numerous periods of mild depression and mild elation. This instability usually develops early in adult life and pursues a chronic course, although at times the mood may be normal and stable for months at a time. The mood swings are usually perceived by the individual as being unrelated to life events. The diagnosis is difficult to establish without a prolonged period of observation or an unusually good account of the individual's past behaviour. Because the mood swings are relatively mild and the periods of mood elevation may be enjoyable, cyclothymia frequently fails to come to medical attention. In some cases this may be because the mood change, although present, is less prominent than cyclical changes in activity, self-confidence, sociability, or appetitive behaviour. If required, age of onset may be specified as early (in late teenage or the twenties) or later.

The essential feature is a persistent instability of mood, involving numerous periods of mild depression and mild elation, none of which has been sufficiently severe or prolonged to fulfill the criteria for bipolar disorder or recurrent depressive disorder. This implies that individual episodes of mood swings do not fulfill the criteria for any of the categories described under manic episode or major depressive episode.

Differential Diagnosis

This disorder is common in the relatives of patients with bipolar disorder and some individuals with cyclothymia eventually develop bipolar disorder themselves. It may persist throughout adult life, cease temporarily or permanently, or develop into more severe mood swings meeting the criteria for bipolar disorder or recurrent depressive disorder in rare cases.

Causes

Cyclothymia appears to have a genetic contribution, which has been shown by a range of twin studies involving dizygotic (fraternal) and monozygotic (identical) twins.[How to reference and link to summary or text]

Psychosocial factors have also been implicated, for example stressful life events or living conditions, and interpersonal difficulties. In addition, some unsupported theories posit that the hypomanic episodes have meaning in the context of a person seeking to achieve goals or to avoid depression.[How to reference and link to summary or text]

Treatment

Treatment for cyclothymia can include a variety of cognitive behavioral therapy techniques. Additionally, mood stabilizers, such as lithium and medications for anxiety and mood stabilization such as benzodiazepines, are often prescribed in low doses to treat Cyclothymia.


See also

References

External links

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