Saygın Salih EKER, Cengiz AKKAYA, ŞENGÜL CANGÜR, Aslı SARANDÖL, Ebru YAVAŞÇI ÖZTEPE, Ülkü SARIKAVAKLI, Selçuk KIRLI

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

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

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

Objective: The aim of this study was to determine the distribution and severity of depression symptoms, functional 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 dysthymic disorder (DD) according to DSM-IV were included. Patients with double depression, ongoing major depression, axis I or II diagnosis and uncontrolled physical illness were excluded. Patients were evaluated using Hamilton 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 correlated 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.

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