Related Experiment Videos
Early- versus late-onset dythymic disorder: comparison in out-patients with superimposed major depressive episodes
D N Klein1, A F Schatzberg, J P McCullough
1Department of Psychology, State University of New York at Stony Brook, 11794-2500, USA. dklein@ccvm.sunysb.edu
Background:
This study examined the validity of the early-late onset subtyping distinction in dysthymic disorder.
Methods:
Participants were 340 out-patients meeting DSM-III-R criteria for dysthymia and a concurrent major depressive episode (MDE). The sample was drawn from a 12-site double-blind randomized parallel group trial comparing the efficacy of sertraline and imipramine in the treatment of chronic depression. All patients received comprehensive evaluations using semi-structured interviews and rating scales.
Results:
73% of the sample met criteria for the early-onset, and 27% for the late-onset, subtype. The early-onset patients had a significantly longer index MDE, significantly higher rates of personality disorders and lifetime substance use disorders, and a significantly greater proportion had a family history of mood disorder. The subgroups did not differ in symptom severity or functional impairment at baseline, nor in response to a 12-week trial of antidepressants.
Limitations:
Further work is needed to extend these findings to dysthymic disorder without superimposed MDEs.
Conclusions:
These results support the distinction between early-onset and late-onset dysthymic disorder.