Materiały źródłowe

• #1 Dysthymia – Wikipedia

  https://en.wikipedia.org/wiki/Dysthymia

  Dysthymia, known as persistent depressive disorder (PDD) in the DSM-5-TR, is a psychiatric condition marked by symptoms that are similar to those of major depressive disorder, but which persist for at least two years in adults and one year among pediatric populations. […] PDD is defined by a 2-year history of symptoms of major depression not better explained by another health condition, as well as significant distress or functional impairment. […] There are no known biological causes that apply consistently to all cases of dysthymia, which suggests diverse origin of the disorder. […] However, there are some indications that there is a genetic predisposition to dysthymia: „The rate of depression in the families of people with dysthymia is as high as fifty percent for the early-onset form of the disorder.

• #2 Persistent depressive disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/syc-20350929

  Persistent depressive disorder is a continuous, long-term form of depression. […] The exact cause of persistent depressive disorder is not known. As with major depression, it may involve more than one cause, such as: […] People with persistent depressive disorder may have physical changes in their brains. It’s not clear how these changes affect the disorder, but they may eventually help determine the causes. […] Research indicates that changes in neurotransmitters may play a large part in depression and its treatment. […] Persistent depressive disorder appears to be more common in people whose blood relatives also have the condition. Researchers are trying to find genes that may be involved in causing depression. […] As with major depression, traumatic events such as the loss of a loved one, financial problems or a high level of stress can trigger persistent depressive disorder in some people.

• #3 Persistent Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541052/

  Persistent depressive disorder (PDD) was a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013 that combined dysthymia and chronic major depressive disorder. […] The pathophysiology of persistent depressive disorder is unknown. No studies of PDD exist, and older studies of dysthymia and chronic major depressive disorder have not been replicated. Early research implicated serotonergic abnormalities, immune system dysregulation, neuroendocrine alterations, and sleep alterations. Only a few gene studies are available, flawed by the small study sizes and the absence of replication attempts and genome-wide approaches. Brain imaging has not demonstrated any firm conclusions about brain structure or neural network function in PDD, although the prefrontal cortex, anterior cingulate, amygdala, and hippocampus have been implicated. Polysomnographic abnormalities may exist in PDD.

• #4 Persistent Depressive Disorder | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20811

  Biopsychosocial conceptualizations postulate that depression is a multifactorial disease state caused by biological, social, psychological, and spiritual factors. […] Risk factors for persistent depressive disorder may include genetics, epigenetics, prior mental illness, neuroticism, high anxiety states, sense of self-worth, psychological health, trauma, life stressors, and social determinants of health. […] Antecedents of chronic depression include greater childhood adversity and maltreatment, childhood loss of a parent, higher rates of chronic depression in relatives, and earlier onset of depression. […] There are high rates of comorbidity between PDD and borderline personality disorder, which is a risk factor for PDD, suggesting that the disorders may share etiological factors such as genetics, temperamental vulnerability, interpersonal stress, or childhood maltreatment.

• #5 Pathophysiology of depression | PPT

  https://www.slideshare.net/NemkumarJain2/pathophysiology-of-depression-93240319

  Major depressive disorder, also known as clinical depression, is characterized by a persistent low mood and loss of interest over at least two weeks. […] The pathophysiology of depression involves deficiencies in neurotransmitters like serotonin, norepinephrine, and dopamine according to the monoamine hypothesis. […] The neurotrophic hypothesis also links low levels of brain-derived neurotrophic factor to loss of neurons and brain atrophy. […] Pathophysiology 1) Monoamine Hypothesis: depression is related to a deficiency in the amount or function of cortical and limbic serotonin (5- HT), norepinephrine (NE), and dopamine (DA). […] Patho-physiology 2) Neurotrophic hypothesis: Brain Derived growth factor (BNDF) promotes the growth and development of immature neurons including mono-aminergic neurons, enhances the survival and function of adult neurons. Low BNDF level may be responsible for loss of mono-aminergic neurons and loss of function or atrophy of hippocampus and other brain areas.

• #6 Major Depressive Disorder: Pathophysiology and Clinical Managemen

  https://www.longdom.org/open-access/major-depressive-disorder-pathophysiology-and-clinical-management-30556.html

  The mesolimbic dopamine system that consists of the nucleus accumbens (NAc) and the ventral tegmental area (VTA) also are believed to play a role in the pathogenesis of depression. […] Chronic stress and hyperactivity of the HPA axis (causing chronic hypercortisolemia) have been hypothesized to play a prominent role in the incidence of depression and even in recurrence after complete remission. […] There is now a compelling argument that in order for depression to surface there needs to be a complex gene-environmental interaction that alters an individual response to stressful life situations. […] The monoamine hypothesis of depression came into the picture after the serendipitous discovery of the first antidepressant drugs that were otherwise developed for other medical conditions. […] The claim that depression is an inflammatory disorder is gaining popularity nowadays.

• #7 Major vs. persistent depressive disorder: Understanding dysthymia

  https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder

  Research into the causes of PDD is ongoing, but scientists believe that the disruption of the neurotransmitters serotonin, epinephrine, norepinephrine, and glutamate plays a role. […] Researchers have also found that certain parts of the brain, such as the orbitofrontal cortex and the hippocampus, are smaller in people with PDD than in those without. […] Other causes of PDD are genetic, environmental, and psychological. Some of these include: serious medical conditions, such as diabetes and cancer; a personal or family history of depression; trauma or chronic stress; certain medications that can cause depression as a side effect. […] Genetic, social, and physical factors cause PDD and MDD. Various parts of the brain play important roles in the development of these disorders.

• #8 Anhedonia and Depressive Disorders

  https://www.cpn.or.kr/view.html?uid=1533&vmd=Full

  Anhedonia is a core symptom of depression and of several psychiatric disorders. […] Anhedonia has also been linked to inflammation with a possible reciprocal deleterious effect on depression. Its neurophysiological bases mainly include alterations in striatal and prefrontal areas, with dopamine being the most involved neurotransmitter. […] The prefrontal cortex, including the ventromedial prefrontal cortex and the dorsolateral prefrontal cortex, plays a critical role in reward processing and decision-making. But probably the most relevant mechanism at the basis of anhedonia is the striatal hypoactivation for anticipatory anhedonia while prefrontal areas for consummatory anhedonia. […] Anhedonia is thought to have a significant genetic component and recent reports suggest a substantial heritability, that is inherent genetic predisposition.

• #9 Genetic Variants associated with Persistent Depressive Disorder

  https://www.mathewsopenaccess.com/full-text/genetic-variants-associated-with-persistent-depressive-disorder

  The MAOA gene polymorphisms such as rs1137070, 941T-G, and rs1799835, an intron-2 dinucleotide repeat, and functional length polymorphism in the upstream region of VNTR (u-VNTR) were observed to affect the in-vitro transcriptional efficacy of neuroactive amines and also in several behavioral and neuropsychiatric illnesses such as the PD, ADHD, MDD, BD, and AD. […] The 5-HTTLPR (5-Hydroxytryptamine transporter-linked polymorphic region) is a 5 proximal del-ins polymorphism which is linked with the transcriptional efficiency and decreased functioning of 5-HTT, which in turn, was related to altered serotonin uptake from the synaptic clefts. […] The involvement of this gene polymorphism in some psychiatric disorders was not reported. […] A study determined that the BDNF serum concentrations are higher in dysthymias than those of the MDD patients, and was also observed with a nominal difference when compared with controls.

• #10 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. Exact cause is unknown but probably involves heredity, changes in neurotransmitter levels, altered neuroendocrine function, and psychosocial factors. […] The exact cause of depressive disorders is unknown, but genetic and environmental factors contribute. Heredity accounts for about half of the etiology (less so in late-onset depression). Thus, depression is more common among first-degree relatives of depressed patients, and concordance between identical twins is high. Also, genetic factors probably influence the development of depressive responses to adverse events. […] Other theories focus on changes in neurotransmitter levels, including abnormal regulation of cholinergic, catecholaminergic (noradrenergic or dopaminergic), glutamatergic, and serotonergic (5-hydroxytryptamine) neurotransmission. Neuroendocrine dysregulation may be a factor, with particular emphasis on 3 axes: hypothalamic-pituitary-adrenal, hypothalamic-pituitary-thyroid, and hypothalamic-pituitary-growth hormone. […] Psychosocial factors also seem to be involved. Major life stresses, especially separations and losses, commonly precede episodes of major depression; however, such events do not usually cause lasting, severe depression except in people predisposed to a mood disorder.

• #11 Pathophysiology of depression | PPT

  https://www.slideshare.net/NemkumarJain2/pathophysiology-of-depression-93240319

  Pathophysiology 3) Neuroendocrine hypothesis: Dexamethasone suppression test doesn’t reduce cortisol level in 50% of depression patients; indicates imbalance in stress HPA axis (hypothalamus-pituitary-adrenal gland axis). Dysregulation in HPA axis results in increased corticotropin releasing factor (CRF) from hypothalamus (result of hippocampus atrophy), Enlarged adrenal gland and increased secretion of cortisol (glucocorticoids).

• #12 Major Depressive Disorder: Pathophysiology and Clinical Managemen

  https://www.longdom.org/open-access/major-depressive-disorder-pathophysiology-and-clinical-management-30556.html

  Significant atrophy of certain prefrontal cortex areas and hippocampus observed in depression as well as decreased levels of nerve growth factors (NGF) such as BDNF has led to the neurotrophic hypothesis. […] There is increasing evidence that this neuropeptides are involved in the modulation of stress-related behaviors and mood by acting on neurokinin type-1 receptors (NK-1). […] Thyroid hormones (TH) imbalances are implicated in the pathophysiology of neurodegenerative and psychiatric conditions. […] Increased female susceptibility to depression mostly overlaps periods of low estrogen levels in the menstrual cycle, postpartum and after the onset of menopause. […] Arginine vasopressin (AVP) is a hypothalamic hormone that influences some key symptoms pertinent to major depressive disorder. […] Melatonin, a hormone secreted by the pineal gland, in a circadian fashion, regulates the rhythm of various biological parameters like body temperature, cortisol secretion, and sleep cycles by acting on receptors in the suprachiasmatic nucleus (SCN) of the hypothalamus.

• #13 Dysthymia – Wikipedia

  https://en.wikipedia.org/wiki/Dysthymia

  A new model has recently surfaced in the literature regarding the HPA axis (structures in the brain that get activated in response to stress) and its involvement with dysthymia (e.g. phenotypic variations of corticotropin releasing hormone (CRH) and arginine vasopressin (AVP), and down-regulation of adrenal functioning) as well as forebrain serotonergic mechanisms. […] There is evidence that there may be neurological indicators of early onset dysthymia. […] Another study, which used fMRI techniques to assess the differences between individuals with dysthymia and other people, found additional support for neurological indicators of the disorder. […] This provides neurological evidence of the dulling of emotion that individuals with dysthymia have learned to use to protect themselves from overly strong negative feelings, compared to healthy people. […] There is some evidence of a genetic basis for all types of depression, including dysthymia.

• #14 Anhedonia and Depressive Disorders

  https://www.cpn.or.kr/view.html?uid=1533&vmd=Full

  The presence of more severe anhedonia may lead to a more severe disease course. […] Higher levels of anhedonia in depression have been linked to higher suicidal ideation both in cross-sectional and longitudinal studies. […] The relationship between anhedonia and inflammation may be bidirectional, meaning that inflammation may contribute to the physiopathology of anhedonia, and anhedonia may also influence inflammation by reducing engagement in anti-inflammatory behaviors, such as exercise and social interactions. […] Traditional antidepressants, such as selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, are first line treatments for depression and its associated symptoms, including anhedonia. However, their effectiveness in treating anhedonia is limited, with evidence of partial or no improvement in anhedonia with antidepressant medication alone.

• #15 Genetic Variants associated with Persistent Depressive Disorder

  https://www.mathewsopenaccess.com/full-text/genetic-variants-associated-with-persistent-depressive-disorder

  The increased production of IL-1 and IL-6 levels was observed in MDD and Dysthymia (cells induced by mitogen), the IL-1 levels are highly correlated with onset age and duration of the illness. […] The association of the A allele of PRKCDBP rs1488864 was reported with MDD, depressive disorders in general or (and) dysthymia by Kovanen and colleagues. […] FK506 binding protein 5 is found to be connected with regulating the GR (glucocorticoid receptor) sensitivity of cortisol, and consequently, the FKBP5 gene expression affects the cortisol secretion.

• #16 Persistent Depressive Disorder | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20811

  The pathophysiology of persistent depressive disorder is unknown. […] Early research implicated serotonergic abnormalities, immune system dysregulation, neuroendocrine alterations, and sleep alterations. […] Only a few gene studies are available, flawed by the small study sizes and the absence of replication attempts and genome-wide approaches. […] Brain imaging has not demonstrated any firm conclusions about brain structure or neural network function in PDD, although the prefrontal cortex, anterior cingulate, amygdala, and hippocampus have been implicated. […] Polysomnographic abnormalities may exist in PDD.

• #17 Persistent Depressive Disorder, Dysthymia, and Chronic Depression: Update on Diagnosis, Treatment

  https://www.psychiatrictimes.com/view/persistent-depressive-disorder-dysthymia-and-chronic-depression-update-diagnosis-treatment

  Since chronic forms of depression have typically been studied jointly with the episodic forms of depressive disorders, relatively less is known about the causation of PDD. However, existing data indicate partly overlapping and partly specific genetic and environmental factors. Persistent forms of depression run in families jointly with episodic recurrent depression. In addition to a general familial disposition to depressive disorders, there also appears to be a specific familial contribution to chronicity. Familial disposition to dysthymia also overlaps with liability for personality disorders. Findings from a study of twins suggest that the overlap is due to genetic factors. One study of severe hospital-ascertained MDD in twins found that stronger heritability was associated with a greater number but shorter duration of episodes, which suggests that persistent depression might be less heritable than episodic depression. It is therefore likely that some of the familial aggregation of persistent forms of depression is due to environmental factors that are also shared within families.

• #18 Genetic Variants associated with Persistent Depressive Disorder

  https://www.mathewsopenaccess.com/full-text/genetic-variants-associated-with-persistent-depressive-disorder

  Genetic association of a depressive disorder is vital for clinical-based studies, and also many researchers have suggested that common genetic variants, gene expression and pathways are related to depression. Thus, it is established those candidate genes are involved in the pathological process of depressive disorder such as CRY1, CRY2, MAOA, 5-HTT; BDNF, IL, and FKBP5 are mainly concerned with anxiety and depressive disorders. […] To conclude, our findings in genetic literature confirms that association studies of candidate genes point to potential risk loci of persistent depressive disorder may play an important role in early stage identification and pathogenic risk assessment, thereby reducing the incidence among the PDD human community. […] The genetic association studies of dysthymia state that CRY2 and CRY1 are not associated with DD, but haplotype analysis reported rs10838524, rs7121611, rs7945565, and rs1401419 to be associated with dysthymia.

• #19 Persistent Depressive Disorder, Dysthymia, and Chronic Depression: Update on Diagnosis, Treatment

  https://www.psychiatrictimes.com/view/persistent-depressive-disorder-dysthymia-and-chronic-depression-update-diagnosis-treatment

  Environmental adversity is associated with depression in general and even more so with persistent depression. A history of childhood maltreatment, including physical abuse, sexual abuse, and emotional abuse and neglect, is especially strongly associated with persistent forms of depression. Regardless of treatment, patients with a history of childhood maltreatment were more likely to have a chronic course of illness. The long-term relationship between childhood maltreatment and perpetuation of depression into a chronic course appears to be strong, robust, and independent of environmental risk factors measured in adulthood. The genetic and environmental factors that contribute to persistent depression are unlikely to be independent of each other. The short variants of the serotonin transporter gene promoter length polymorphism specifically sensitize individuals to develop chronic and persistent, but not transient or episodic, depression in adulthood following childhood exposure to maltreatment. This gene-environment interaction is perhaps the first example of a distinct causative mechanism specific to PDD. It remains to be established whether the knowledge of causation can inform and improve treatment.

• #20 Persistent Depressive Disorder Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/persistent-depressive-disorder

  The cause of persistent depressive disorder is unknown, but symptoms can stem from a variety of factors, including chronic stress and trauma at an early age. […] Recent research indicates that changes in the function and effects of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.

• #21 Anhedonia and Depressive Disorders

  https://www.cpn.or.kr/view.html?uid=1533&vmd=Full

  Anhedonia may be more effectively treated with a variety of different antidepressants, such as bupropion, dextromethorphan combined with bupropion, agomelatine, ketamine and transcranial magnetic stimulation. […] Anhedonia is one of the hallmark symptoms of depression as well as a number of other mental conditions. […] It has then been shown that anhedonia is a meaningful risk factor for prospective suicidal behaviours, and that it may function as a potentially independent risk factor for suicidality separate from the depression itself.

• #22 Persistent Depressive Disorder & Substance Use | Dual Diagnosis

  https://www.burningtree.com/dual-diagnosis/depressive-disorders/persistent-depressive-disorder/

  Individuals with Persistent Depressive Disorder (PDD), also known as dysthymia, may turn to substance abuse as a coping mechanism for their chronic symptoms of depression. […] The DSM-5’s classification of Persistent Depressive Disorder acknowledges the unique challenges posed by this long-term form of depression, emphasizing the need for early detection and sustained treatment efforts to manage symptoms and improve quality of life. […] Treatment typically involves a combination of psychotherapy (especially cognitive-behavioral therapy) and medication (such as SSRIs). Because of the chronic nature of PDD, long-term treatment strategies are often necessary. […] Addressing substance abuse in individuals with PDD is crucial, as it can significantly impact the effectiveness of depression treatment. Integrated treatment approaches that focus on both depressive symptoms and substance use disorders are often necessary. […] Understanding the link between substance abuse and Persistent Depressive Disorder is essential for providing comprehensive care and support to those affected, highlighting the importance of integrated treatment strategies.

• #23 Persistent Depressive Disorder (PDD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd

  Scientists dont fully understand what causes persistent depressive disorder. Most likely, depression is caused by abnormal connections between different parts of your brain, preventing your brain cells from communicating with each other as they should. […] The most effective persistent depressive disorder treatment combines medications and talk therapy, or counseling. […] Antidepressants are prescription drugs that can relieve depression. There are many different kinds of medications for the treatment of depression. You may need to take medication for a month or longer before you feel a difference. Make sure to continue taking the medication exactly as your healthcare provider prescribes. If you have side effects, let your healthcare provider know. […] Counseling can also help manage persistent depressive disorder. One type of therapy, cognitive behavioral therapy (CBT), is often helpful for depression. A therapist or psychologist will help you examine your thoughts and emotions and how they affect your actions. CBT can help you unlearn negative thoughts and develop more positive thinking.

• #24 What is Persistent Depressive Disorder? | Charlie Health

  https://www.charliehealth.com/post/what-is-persistent-depressive-disorder-symptoms-causes-and-treatment

  Persistent depressive disorder is a chronic mental health disorder that frequently begins during childhood or adolescence and can continue for life. […] Similar to other forms of depression, the exact cause of persistent depressive disorder is unknown, but research suggests that it might stem from some of the following genetic and circumstantial factors: […] Antidepressants are prescription medications that are frequently used to treat different types of depression, including persistent depressive disorder. […] A study that followed 23 people with PDD for 9 years found that one of the most important components of treatment and recovery is having a team of healthcare providers that you can learn from and trust. […] The process for diagnosing persistent depressive disorder is very similar to that of major depressive disorder.

• #25 Major Depressive Disorder: Pathophysiology and Clinical Managemen

  https://www.longdom.org/open-access/major-depressive-disorder-pathophysiology-and-clinical-management-30556.html

  Depression is a chronic mental disorder that causes changes in mood, thoughts, behavior and physical health. […] There are diverse theories on the pathogenesis of depression most based on measurement of indirect markers, post-mortem studies and neuro-imaging techniques. […] Even though there are numerous studies attempting to shed light on the pathophysiology of depression, it still remains elusive. This is in fact the major reason for the slow paced drug development against this disease. There are diverse theories on the pathogenesis of depression most based on measurement of indirect markers, post-mortem studies and neuro-imaging techniques. […] Various structural and functional studies report abnormalities in the areas of the brain that are responsible for the regulation of mood, reward response and executive functions.

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