What are the types of dysthymia?

Updated: Oct 01, 2019
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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Niculescu and Akisal proposed that dysthymia be divided into 2 subtypes: anxious dysthymia and anergic dysthymia. They described the subset of patients with anxious dysthymia as having pronounced symptoms of low self-esteem, undirected restlessness, and interpersonal rejection sensitivity. They also characterized these patients as help-seeking and more likely to make lower-lethality suicide attempts and to have a better response to selective serotonin reuptake inhibitors (SSRIs). Substances of choice for these patients include benzodiazepines, alcohol, marijuana, opiates, and possibly food. (See Treatment and Medication.) [2]

This group is compared with persons who have anergic dysthymia, characterized by low energy, hypersomnia, and anhedonia. Patients with anergic dysthymia, the authors suggest, may have a better response to treatment with agents that increase norepinephrine or dopamine. (See Treatment and Medication.)

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