Cyclothymic Disorder

 

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Diagnostic Guidelines

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 fulfil the criteria for bipolar affective disorder or recurrent depressive disorder. This implies that individual episodes of mood swings do not fulfil the criteria for any of the categories described under manic episode or depressive episode.

Includes:

  1. affective personality disorder
  2. cycloid personality
  3. cyclothymic personality

Differential Diagnosis

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

ICD-10 copyright 1992 by World Health Organization.

Diagnostic Criteria For Cyclothymia From the DSM IV: 

  • For at least 2 years, the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a Major Depressive Episode.
  • Note: In children and adolescents, the duration must be at least 1 year.
  • During the above 2-year period (1 year in children and adolescents), the person has not been without the symptoms in Criterion A for more than 2 months at a time.
  • No Major Depressive Episode, Manic Episode, or Mixed Episode has been present during the first 2 years of the disturbance.
  • Note: After the initial 2 years (1 year in children and adolescents) of Cyclothymic Disorder, there may be superimposed Manic or Mixed Episodes (in which case both Bipolar I Disorder and Cyclothymic Disorder may be diagnosed) or Major Depressive Episodes (in which case both Bipolar II Disorder and Cyclothymic Disorder may be diagnosed).
  • The symptoms in Criterion A are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
  • The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

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