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19.07.2014

Cyclothymic disorder symptoms adults, why do you hear ringing in your ears after a concert - How to DIY

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Bipolar Disorder (BD) is a mood disorder in which individuals experience varying episodes of mania, hypomania, hyperthymia and depression [1].
The depressive episodes in Cyclothymia resemble depression in several aspects including decreased confidence and motivation, listlessness, affected sleep, feelings of worthlessness and guilt, emotional instability and irritability [10]. Typically, the Structured Clinical Interview for DSM-IV-TR Axis I disorders (SCID-I) is used as a diagnostic tool, though it is used for the diagnosis for BD in general and may underdiagnose Cyclothymia [15].
Akiskal and collegues developed a self-report questionnaire known as the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire (TEMPS-A), which has been useful for identifying Cyclothymia [17]. A circadian component of Cyclothymia has long been alluded to abstractly, but never formally investigated. In another paper, Lara, Ottoni and colleagues show that Cyclothymic temperaments are associated with sleep disturbances [26].
Very few functional Magnetic Resonance Imaging (fMRI) studies differentiate between Cyclothymia and other BD subtypes, and there are no fMRI studies on Cyclothymia alone. There have been a few studies that showed that Lithium, the conventional treatment for bipolar disorder, might have positive effects on cyclothymics.
Although BD is generally treated with pharmaceuticals, physchosocial treatments have been shown to be more appropriate and effective for cyclothymics. Poor diagnosis of Cyclothymia has undoubtedly hindered the development of effective treatments [34].
In DSM-5, the diagnosis of cylothymic disorder is more restrictive in that patients who have ever had a major depressive, manic, or hypomanic episode in the past can no longer receive this diagnosis. The four classified subtypes of BD are bipolar I and II, Cyclothymia and bipolar NOS (Not Otherwise Specified). Many do not recognize Cyclothymia as a distinct disorder, but rather as a temperament trait or a co-morbid characteristic, despite its classification in the DSM-IV since 1980 [6][7][8]. Neither the hypomanic symptoms nor the depressive symptoms are severe or frequent enough to qualify for a manic episode or a major depression episode respectively, however they do cause noticeable change in functioning in daily life [5].
Youngstrom and colleagues found that approximately 50% of Cyclothymic individuals have at least one comorbid Axis I disorder [13]. The Mood Disorder Questionnaire (MDQ), which contains questions on mania and hypomania, may also be used as a screening tool along with an unstructured review of the symptoms [16]. This questionnaire measures temperament on four subscales: dysthymic, cyclothymic, hyperthymic and irritable temperament [18].
This is due in part to the lack of diagnostic tools for Cyclothymia, however there are more useful tools on the rise.
To date, there is only one study that showed that there might be an association between Cyclothymia and a hypoactive ventral prefrontal cortex, specifically the inferior frontal gyrus [9]. One study showed that cyclothymics that were treated with Lithium had higher remission rates than the control group of untreated cyclothymics [27].


In contrast to pharmacological treatments that are aimed at mood states, psychosocial interventions concentrate on regulating the mood variability associated with Cyclothymia. Integrating circadian mood regulation in the treatment of Cyclothymia can significantly improve the effectiveness of the treatment [32].
Don't forget to link it to your parent page though :) Since both of our wikis focus on psychiatric disorders, I'll be linking your page with mine.
I actually read in one paper that individuals from families with a history of bipolar disorder, were more prone to cylothymia if they functioned on a later circadian rhythm and a later sleep chronotype. This disagreement in the literature is impeding our understanding of Cyclothymia and this neglect needs to be revised. These symptoms must have been present for a minimum of two years for adults but only one year for children and adolescents [5]. In the literature, the depressive episodes of Cyclothymia are better characterized than the hypomanic episodes.
It has also been shown that Cyclothymia is significantly more prevalent in adults with Attention Deficit Hyperactive Disorder (ADHD) [14]. Most of the diagnostic tools being used for Cyclothymia are for the diagnosis of bipolar disorder in general. Lara, Ottoni and colleagues provide some insight in this aspect and provide some evidence that cyclothymics have an altered circadian rhythm and possibly a cycling pattern that is synchronized to that circadian cycle [25].
They identified that cyclothymics tend to sleep later and also wake up later than average, overall experiencing a lower quality of sleep [26] (see Sleep irregularities).
In two other studies, it was shown that 60% of cyclothymics improved with Lithium treatment compared to only 20% in the control group [8][28].
Totterdell and Kellet show that Cognitive Behavioural Therapy (CBT) effectively helped cyclothymics in recognizing their variable mood states and progress further to managing this mood variability [32]. And you can also link to my page, sleep irregularities in bipolar disorder as well as to the group page, Bipolar Neuroscience. During this one or two year time interval, any period that is free of symptoms cannot exceed two months in duration [5]. The main feature that distinguishes Cyclothymia from the other bipolar subtypes is the absence of major depressive episodes. However, there are a few self-report questionnaires for cyclothymic temperament that have been developed and a few being developed and currently being tested. The cyclothymic subscale of TEMPS-A has shown to be quite promising in identifying Cyclothymia [20].
They successfully showed that after CBT, cyclothymics had reduced mood variability and the intervals between episodes had increased in duration [32].
Lifetime and 12 month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication.


The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases.
Subaffective disorders: dysthymic, cyclothymic and bipolar II disorders in the borderline realm. The neural basis of familial risk and temperamental variation in individuals at high risk of bipolar disorder. Personality and personality disorders among patients with major depression in combination with dysthymic or cyclothymic disorders. Cyclothymic disorder temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder. Sustained remission with lamotrigine augmentation or monotherapy in female resistant depressives with mixed cyclothymic-dysthymic temperament. Low-dose quetiapine for patients with dysregulation of hyperthymic and cyclothymic temperaments. Restructuring mood in cyclothymia using cognitive behavior therapy: an intensive time-sampling study.
The sequential combination of cognitive behavioral treatment and well-being therapy in cyclothymic disorder. In addition, the elevated hypomanic mood states of Cyclothymia tend to be more negatively irritable and impulsive than the manic state of bipolar I, and encompass some feelings of guilt and low self-esteem [12]. This tool recognizes 10 affective temperaments: depressive, anxious, apathetic, cyclothymic, dysphoric, volatile, euthymic, hyperthymic, irritable and disinhibited, on 5 emotional dimensions [23]. Papers providing this type of information are helpful in providing better diagnostic instruments for Cyclothymia as well as better treatments, or rather, better timing of treatment administration.
In a study with individuals experiencing mood instability similar to cyclothymics, Valproic acid, an anticonvulsant drug more commonly known as Valproate, proved to be an effective mood-stabilizer, reducing the unstable symptoms in 68% of the subjects [30]. They show that cyclothymics (and euphorics) have a later circadian preference and tend to have more mood swings [25]. Treatment of Quetiapine, an atypical antipsychotic popularly known as Seroquel, at very low doses can ameliorate symptoms in individuals experiencing mild to moderate mood cycling symptoms [31]. They were able to show that cyclothymics have later circadian preferences in the energy-based chronotype, as well as the sleep-based chronotype [25]. Reference to "we" or "our" means GME.Our InformationPlease remember that all of the information available through the Service is intended for adults who are licensed healthcare professionals. However, to the best of our ability we will ensure that the other websites that we link to are relevant to our sites content and visitors experience and that they do not contain adult, drugs or gambling content.Your GME account information is protected by a password for your privacy and security.



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