Diagnosis and Treatment of Cyclothymia: The "Primacy" of Temperament

Current Neuropharmacology
Giulio PerugiGiulia Vannucchi

Abstract

Contrary to DSM-5 definition based on recurrence of low grade hypomanic and depressive symptoms, cyclothymia is better defined in a neurodevelopmental perspective as an exaggeration of cyclothymic temperament. Emotional dysregulation with extreme mood instability and reactivity is the core features of the complex symptomatology. In the present article, we critically reviewed the literature on the diagnosis and treatment of cyclothymia, focusing on the temperamental and neurodevelopmental perspectives. Current epidemiological and clinical research showed the high prevalence and the validity of cyclothymia as a distinct form of bipolarity, frequently associated with multiple comorbidities with anxiety, impulse control, substance use, and so called "personality" disorders. Many patients receive correct diagnosis and treatments after many years of illness, when the superposition of complications reduces the possibility of complete remission. A therapeutic model combining the focus on symptomatic presentations with a temperamental perspective seems to represent an effective approach for cyclothymic patients with complex clinical presentations. Cyclothymic mood instability is an understudied issue despite the evidence of its clinical...Continue Reading

Citations

Mar 20, 2019·Bipolar Disorders·Carlo Ignazio CattaneoGiulio Perugi
Jun 12, 2020·Acta Psychiatrica Scandinavica·S A Barroilhet, S N Ghaemi
Nov 1, 2017·The International Journal of Neuropsychopharmacology·Gabriele Sachs, Andreas Erfurth
Oct 6, 2020·Journal of the American Association of Nurse Practitioners·Donna RolinCharles B Montano
Oct 11, 2020·Journal of Affective Disorders·Margherita BarbutiGiulio Perugi
Feb 20, 2021·Journal of Affective Disorders·Yidan QiuRuiwang Huang
Jun 3, 2021·Medicina·Giulio Emilio BrancatiGiulio Perugi
Nov 7, 2021·Perspectives in Psychiatric Care·Clara RahmeSahar Obeid
Nov 12, 2021·Frontiers in Psychiatry·Frank W PaulusChristian Popow
Nov 24, 2021·European Psychiatry : the Journal of the Association of European Psychiatrists·Alessandro MiolaLeonardo Tondo

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