Examining the Course of Cyclothymic Disorder and Comparing it to Dysthymic Disorder and Other Bipolar Spectrum Disorders in Children

Cyclothymic disorder has been an under-investigated diagnosis despite its association with impaired functioning and with later bipolar I or II disorder. Cyclothymic disorder in children is characterized by chronic mood fluctuations that cycle between periods of depression and hypomania that do not meet diagnostic criteria for a full episode. Diagnosis of this disorder is complicated given its non-episodic nature and similarity to other disorders such as attention-deficit/hyperactivity disorder (ADHD); however, it can be identified differentially by its association with high mood lability, emotional overactivity, and impulsive-aggressive behaviors. Investigation of the course of this disorder relative to other mood disorders particularly dysthymic disorder will add to understanding of how to conceptualize bipolar spectrum disorders in general and how to treat cyclothymic disorder specifically.707 children, 23% with bipolar spectrum disorders, were assessed semiannually for two years as part of the Longitudinal Assessment of Manic Symptoms (LAMS) protocol. Primary outcomes for this analysis were depressive and manic symptom counts, severity and global functional impairment. Independent hierarchical linear models were used to estimate fixed effects of time, mood diagnosis, their interaction, as well as other demographic effects for each primary outcome. Random intercept and slope effects were estimated in each model for time and participants. Results demonstrated that cyclothymic disorder was associated with greater severity and slower improvement in depressive symptoms across time compared with all other mood disorders except for major depression, which demonstrated greater symptom severity. Cyclothymic disorder demonstratedsimilar manic symptom counts, severity, and rate of change as children with another bipolar disorder, and greater number of manic symptoms and severity than children with a depressive spectrum disorder. Global functional impairment was similar across all mood disorders and significantly greater than for children without a mood disorder. Cyclothymic disorder is as impairing and severe as other bipolar spectrum disorders with respect to the longitudinal course of the disorder. It is mentionable that during the course of a specific mood episode (e.g., manic, major depressive, or mixed) at a given time, children with bipolar I or II disorder may demonstrate heightened symptom severity and impairment relative to children with cyclothymic disorder who do not demonstrate such mood episodes; however, children with bipolar I or II disorder may present similarly to children with cyclothymic disorder when in a non-episodic state and in partial remission. Episode status, irritability, and mood lability should be considered when diagnosing and treating cyclothymic disorder and other bipolar disorders in children.

Name thesis:degree_name

Master of Arts

Level thesis:degree_level

masters

Discipline thesis:degree_discipline

Psychology

Grantor dc:publisher

The Ohio State University

Year dc:date

2013

Author dc:creator

• Vesco, Anthony Thomas

Contributors dc:contributor

• Fristad, Mary

• Clinical Psychology
• Psychology

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=osu1364907946

OAI identifier oai:identifier

oai:etd.ohiolink.edu:osu1364907946