Cyclothymia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Synonyms and keywords: Cyclothymic disorder; cyclic disorder

Overview

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").

Differential Diagnosis

• Bipolar and related disorder due to another medical condition and depressive disorder due to another medical condition
• Bipolar I disorder, with rapid cycling
• Bipolar II disorder, with rapid cycling
• Borderline personality disorder
• Substance/medication-induced bipolar and related disorder
• Substance/medication-induced depressive disorder

Epidemiology and Demographics

Prevalence

The prevalence of cyclothymic disorder is 400-1,000 per 100,000 (0.4%-1%) of the overall population.

Risk Factor

• Bipolar I disorder
• Genetic predisposition

Diagnostic Criteria

DSM-V Diagnostic Criteria for Intellectual Disability

“

A. For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode. AND B. During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time. AND C. Criteria for a major depressive, manic, or hypomanic episode have never been met. AND D. The symptoms in Criterion A are not better explained by schizoaffective disorder,schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. AND E. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). AND F. The symptoms cause clinically significant distress or impairment in social, occupational,or other important areas of functioning. Specify if: With anxious distress

”

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.

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.

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

• Dysthymia
• Euthymia
• Ultradian Bipolar Disorder
• Motivation

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