Dysthymia and cyclothymia: historical
origins and contemporary
development
by
Brieger P, Marneros A
Psychiatric Hospital,
Martin Luther University,
Halle-Wittenberg, Germany.
peter.brieger@medizin.uni-halle.de
J Affect Disord 1997 Sep; 45(3):117-26
ABSTRACT
The aim of this article is to review and put in their historical context
today's data, methodologies and concepts concerning subaffective disorders. The
historic roots of dysthymic and cyclothymic disorders--part of the subaffective
spectrum--are essentially Greek, but the first use of the word 'dysthymia' in
psychiatry was by C.F. Flemming in 1844. E. Hecker introduced the term
'cyclothymia' in 1877. K.L. Kahlbaum (1882) further developed the concepts of
hyperthymia, cyclothymia and dysthymia--with possible subthreshold
symptomatology--in 1882. After Kraepelin's rubric of 'manic-depressive
insanity', the term 'dysthymia' was widely forgotten, and 'cyclothymia' became
ill defined. Nowadays the latter term is used in three, partially contradictory,
senses: (1) a synonym for bipolar disorder (K. Schneider), (2) a temperament (E.
Kretschmer) and (3) a subaffective disorder (DSM-IV, ICD-10). A renaissance of
subaffective disorders began with the development of DSM-III. Therapeutically
important research has focused on dysthymic disorder and its relationship to
major depressive disorder, while cyclothymic disorder is relatively neglected;
nonetheless, operationalized as a subaffective dimension or temperament,
cyclothymia appears to be a likely precursor or ingredient of the construct of
bipolar II disorder.
Mania
Bipolar II
Cyclothymia
Antidepressants
Dysphoric mania
Drugs for dysthymia
Dysphoric hypomania
Hardwired happiness?
Subthreshold syndromes
Dysthymia: undertreatment
Dysthymia and cyclothymia
Genius and psychopathology
Dysthymia and the amygdala
Dysthymia, drugs and behaviour
Dysthymia in children and adolescents
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