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Early- versus late-onset dysthymic disorder: comparison in out-patients with superimposed major depressive episodes
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Early- versus late-onset dysthymic disorder: comparison in out-patients with superimposed major depressive episodes JOURNAL OF AFFECTIVE DISORDERS Klein, D. N., Schatzberg, A. F., McCullough, J. P., Keller, M. B., Dowling, F., Goodman, D., Howland, R. H., Markowitz, J. C., Smith, C., Miceli, R., Harrison, W. M. 1999; 52 (1-3): 187-196Abstract
This study examined the validity of the early-late onset subtyping distinction in dysthymic disorder.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.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.Further work is needed to extend these findings to dysthymic disorder without superimposed MDEs.These results support the distinction between early-onset and late-onset dysthymic disorder.
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