A 50-year-old male presents with a 3-year history of irritability, low mood, lack of interest in surroundings and general dissatisfaction with everything. There is no significant disruption in his sleep or appetite. He is likely to be suffering from
Neurotic depression has been renamed as dysthymia or dysthymic disorder in DSM-IV-TR and ICD-10. Dysthymia is defined as any mild depression which is not severe enough to be called a depressive episode and lasts for two years or more. Neurotic depression is usually characterised by the following clinical features:1. Presence of mild to moderate depression.2. Depressive symptoms usually occur in response to a stressful situation but are often quite dispropoionate to the severity of stress.3. Other 'neurotic' symptoms such as anxiety, obsessive symptoms, phobic symptoms, and multiple somatic symptoms, are often present.4. Preoccupation with the stressful condition is common. Other common features include:1. The reactivity of mood is preserved, i.e. the patient is able to emotionally react to the events occurring in his surroundings.2. There may be insomnia or hypersomnia. There is usually difficulty in initiating sleep and sometimes difficulty in awakening in the morning.3. The mood may be worse in the evening, at the end of the day.4. Suicidal threats and gestures are more common than completed suicide. 82 Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.
Major depression
No psychiatric disorder
Dysthymia
Chronic fatique syndrome
Mood disorders