Brief Recurrent Depressive Disorder: Symptoms, Causes and Treatment

Depression is one of the most common and well-known types of disorders in the population. This can have a high impact on the life of the individual, with both inactivity and high irritability.

Traditionally, it has been pointed out that a person is truly depressed if the depressive episode in question lasts longer than 14 days. If this was not the case, it was common for the person not to be diagnosed for the disorder.

However, in recent years extensive research has been conducted which, although it may still appear tentative, has indicated that one can experience true depression over short episodes of time. These episodes are not a mild version of what has been called major depression, as the degree of affectation in an individual’s life can be such that they even commit suicide.

Let’s talk about a disorder whose duration has sparked a wide debate: brief recurrent depressive disorder. We will explain what it is, what is its historical background, what the WHO and APA think about it in addition to differentiating it from other mental disorders.

    What is recurrent brief depressive disorder?

    Short-term recurrent depressive disorder, also called brief recurrent depression, Is a psychological disorder characterized by intermittent depressive episodes. These episodes are not related to the menstrual cycle in women and are short-lived, between 2 and 14 days, most often between 5 and 7 days. The episodes occur about 6 to 12 times a year. After a year, the sum of the days you were depressed can add up to about a month.

    Although the episodes are short, the degree of depression achieved is so severe that it can affect a person’s functionality, In addition to performing autolytic and suicide attempts. In addition, people who suffer from it often suffer from anxiety and irritability.

    Due to the characteristics of the disorder, it can be confused with major depression and other associated disorders, being differentiated not by the severity of the symptoms, but by the duration of the depressive episode.

    Context of the diagnostic label

    Already since the 19th century, some disorders have been observed, the occurrence occurring occasionally and for short episodes, ranging from a few hours to a few days. In the past, these types of mood problems, especially if they manifested as depression, had different names., Such as “periodic melancholy” or “intermittent depression”.

    When the DSM-III (Diagnostic and Statistical Manual of Mental Disorders) was published, based on a large body of psychiatric research, it was explicitly specified among the criteria for depression that the depressive episode should last more than two weeks. Thus, there was no diagnostic label that considered the same symptoms of major depression but with a shorter duration.

    Jules Angst, Swiss psychiatrist, coined the term “ brief recurrent depression ” in 1985 based on epidemiological data and proposed a number of criteria to be able to diagnose this type of mood disorder. Consequently, and thanks to various studies at the European level, the World Health Organization has integrated well into the tenth version of the ICD (International Classification of Diseases) in 1992, while the APA has chosen to propose criteria for provisional diagnoses for this disorder in the fourth edition of the DSM.

    symptoms

    In general, people with recurrent brief depressive disorder suffer from the same symptoms as in major depression. They present with anxiety and irritability, as well as hypersomnia.

    Depression, in general terms, is a symptom and a collection of disorders that can lead to a high degree of impairment in the functioning and adjustment of the person. Also, the life of the patients can be disrupted because of it and can alter the schedules and routines that the person has acquired without suffering from the episode.

      differential diagnosis

      In ICD-10 (), brief recurrent depressive disorder is defined as a disorder that meets specific criteria for mild, moderate and severe depressive episodes. What makes this disorder different from major depression is that lasts shorter, with depressive episodes lasting less than two weeks.

      Thus, a brief recurrent depression does not differ from major depression in the severity of the symptoms, nor should it be considered a mild form of this type of disorder. In depressive episodes, although brief, they are particularly dangerous given the person’s risk of suicide. This is why major depression and recurrent brief depressive disorder are considered two related but different disorders.

      too much differs from major depression with a pattern of seasonal recurrence because the depressive episodes in Brief Recurrent Depressive Disorder occur monthly and are of shorter duration.

      In rapid cycling bipolar disorder, Brief Recurrent Depression has no hypomanic or manic episodes. As for premenstrual dysphoric disorder, it differs because it is not associated with the menstrual cycle.

      It should be noted that this disorder has a strong comorbidity with anxiety disorders, such as generalized anxiety, in addition to being able to initiate the abuse of certain substances and give addiction.

      the causes

      The cause of brief recurrent depression is still unknown, and is most likely a multicausal phenomenon, with many variables influencing its onset. However, it has been pointed out that there might be some sort of relationship between this disorder and bipolar, In addition to relating to possible genetic factors.

      A small group of patients diagnosed with this disorder showed temporal lobe epilepsy.

      prevalence

      Although research on this disorder has so far yielded relatively little data, it is estimated that approximately 5% of the population may suffer at some point in their life from an episode that meets the above characteristics. This frequency reaches 10% in young adults aged 20 to 30 years..

      treatment

      People who experience an episode of this nature may gain greater well-being go to psychotherapy. This facilitates the adoption of habits that weaken the presence of the disorder, to the point of making its effects disappear or of having much less power over people.

      In addition, psychotropic drugs, especially SSRIs, mood stabilizers, such as lithium, and antiepileptics are prescribed in clinical practice. However, drugs alone do not make the disorder go away and their goal is to reduce symptoms in the medium term.

      Bibliographical references:

      • Pezawas L., Wittchen HU, Pfister H., Angst J., Lieb R., Kasper (2003). Re-investigation of brief and recurrent depressive disorder: community sample of adolescents and young adults. Psychol Med; 33 (3): 383-6.
      • Pezawas L., Angst J., Gamma A., Ajdacic V., Eich D., Rossler W. (2003) Brief recurrent depression: past and future. Prog Neuropsychopharmacol Biol Psychiatry; 27 (1): 75-83.
      • Corominas A, Bonet P, Nieto E (1998). Brief recurrent depression successfully treated with lithium. Psychiatry Biol; 44 (9): 927-9.
      • Angst J., Hochstrasser B. (1994). Brief Recurrent Depression: The Zurich Study. J Clin Psychiatry; 55 (suppl.): 3-9.
      • Carta MG, Altamura AC, Hardoy MC, Pinna F., Medda S., Dell’Ossol J., et al. (2003) Is Brief Recurrent Depression an Expression of Mood Spectrum Disorders in Youth? Results from a large sample of 3 communities. Eur Arch Neurosci psychiatry clinic; 253 (3): 149-53.
      • Pezawas L., Angst J., Kasper S. (2005). Brief recurrent depression revisited. International Journal of Psychiatry. A bingdon; 17 (1): 63.
      • Stamenkovic M., Blasbichier T., Riederer F., Pezawas L., Brandstatter N., Aschauer HN, et al. (2001) Fluoxetine treatment in patients with brief recurrent depression. Int Clin Psychopharmacol; 16 (4): 221-6.
      • Montgomery DB, Roberts A., Green M., Bullock T., Baldwin D., Montgomery SA (1994). Ineffectiveness of fluoxetine in brief recurrent depression and suicide attempts. Eur Arch Neurosci psychiatry clinic; 244: pages 211 to 215.

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