PRIMARY DYSTHYMIA - A STUDY OF SEVERAL PSYCHOSOCIAL, ENDOCRINE AND IMMUNE CORRELATES

The relationship between primary dysthymia (chronic, low grade depress ion) and indices of major and minor life stresses, uplifts and coping styles was examined. Additionally, circulating lymphocyte subsets were assessed in dysthymic patients to determine their relationship to str ess/coping factors or plasma levels of cortisol, ACTH or norepinephrin e. Primary dysthymia was found to be associated with increased minor s tressors (daily hassles), reduced uplifts, as well as particular relia nce on emotion-focused rather than problem-oriented coping strategies. Interestingly, among dysthymics, the early onset group exhibited a gr eater degree of hassles and greater emotion-focused coping compared to the late onset subgroup. Although hassles and coping styles were corr elated with depressed mood, only coping styles predicted severity of d epressed affect. It seems that although dysthymia is characterized by increased hassles and reduced uplifts, these variables do not distingu ish between the severity of the depressive affect, whereas the coping styles employed in the face of the increased hassles and reduced uplif ts are more closely aligned with depression severity. Dysthymia was as sociated with elevated levels of circulating natural killer (NK) cells . Since levels of plasma cortisol, ACTH or norepinephrine were not inc reased in the dysthymic subjects, it is likely that the elevated NK ce ll number was unrelated to these neuroendocrine measures. In control s ubjects circulating NK cells were inversely related to the severity of hassles recently encountered, while in dysthymic patients stress and coping factors were unrelated to NK cell numbers. Thus, it appears tha t the altered NK cells in dysthymic patients were not related to the i ncreased stress perception and altered coping which characterize these patients.