DYSTHYMIA AND CYCLOTHYMIA - HISTORICAL ORIGINS AND CONTEMPORARY DEVELOPMENT

The aim of this article is to review and put in their historical conte xt today's data, methodologies and concepts concerning subaffective di sorders. The historic roots of dysthymic and cyclothymic disorders - p art of the subaffective spectrum - are essentially Greek, but the firs t use of the word 'dysthymia' in psychiatry was by C.F. Flemming in 18 44. 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. Afte r Kraepelin's rubric of 'manic-depressive insanity', the term 'dysthym ia' was widely forgotten, and 'cyclothymia' became ill defined. Nowada ys 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 ren aissance of subaffective disorders began with the development of DSM-I II. Therapeutically important research has focused on dysthymic disord er and its relationship to major depressive disorder, while cyclothymi c disorder is relatively neglected; nonetheless, operationalized as a subaffective dimension or temperament, cyclothymia appears to be a lik ely precursor or ingredient of the construct of bipolar II disorder. ( C) 1997 Elsevier Science B.V.