Sansone Randy A, Sansone Lori A
Dr. R. Sansone is a professor in the Departments of Psychiatry and Internal Medicine at Wright State University School of Medicine in Dayton, Ohio, and Director of Psychiatry Education at Kettering Medical Center in Kettering, Ohio.
Psychiatry (Edgmont). 2009 May;6(5):46-51.
This ongoing column is dedicated to the challenging clinical interface between psychiatry and primary care-two fields that are inexorably linked.Dysthymic disorder is a smoldering mood disturbance characterized by a long duration (at least two years in adults) as well as transient periods of normal mood. The disorder is fairly common in the US general population (3-6%) as well as in primary care (7%) and mental health settings (up to one-third of psychiatric outpatients). While the etiology of dysthymia remains unknown, there appears to be a genetic susceptibility, which may manifest in the presence of various psychosocial stressors. While the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria are fairly clear, the disorder can be easily under-recognized for a variety of reasons. Treatment may include pharmacotherapy and psychotherapy, although the overall treatment course is oftentimes characterized by protracted symptoms and relapses.
本连载专栏致力于探讨精神病学与初级保健这两个紧密相连领域之间具有挑战性的临床界面。恶劣心境障碍是一种隐匿的情绪紊乱，其特征为持续时间长（成年人至少两年）以及情绪正常的短暂时期。该障碍在美国普通人群中相当常见（3%-6%），在初级保健机构中也较为常见（7%），在心理健康机构中同样常见（高达三分之一的精神科门诊患者）。虽然恶劣心境障碍的病因尚不清楚，但似乎存在遗传易感性，这可能在各种心理社会应激源存在时显现出来。尽管《精神障碍诊断与统计手册》的诊断标准相当明确，但由于各种原因，该障碍很容易被漏诊。治疗可能包括药物治疗和心理治疗，不过总体治疗过程往往具有症状迁延和复发的特点。
