Cyclothymic Disorder
A 32-year-old woman describes more than two years of frequent mood swings, alternating between periods of mildly elevated energy and productivity and periods of low mood and fatigue. Neither type of period has ever met full criteria for a hypomanic or a major depressive episode, she has never been symptom-free for more than a month at a time, and she has never had psychotic symptoms. Which is the most likely diagnosis?
- A.Bipolar I disorder
- B.Cyclothymic disorderCorrect
- C.Persistent depressive disorder
- D.Major depressive disorder
Explanation
Cyclothymic disorder is a chronic condition of at least two years with numerous periods of hypomanic and depressive symptoms that never reach full episode criteria, with symptom-free intervals no longer than two months. It represents a milder bipolar-spectrum illness without full manic, hypomanic, or major depressive episodes.
Why each option
- A.
- Bipolar I requires a full manic episode, which has never occurred.
- B.
- Chronic subthreshold mood swings for over two years define cyclothymic disorder.
- C.
- Persistent depressive disorder lacks the recurrent hypomanic-range periods.
- D.
- Major depressive disorder requires a full major depressive episode, absent here.
Reference: DSM-5-TR, 2022
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