title: Clinical configuration of cyclothymic disturbances.
abstract: OBJECTIVE
  While there is an increasing recognition of the role of subthreshold symptomatology in bipolar disorder, little attention has been dedicated to its only formally acknowledged subtype, cyclothymic disorder. The aim of this investigation was to provide a controlled evaluation of DSM-IV cyclothymic disorder by using a broad assessment strategy geared to subclinical signs.
  
  
  METHODS
  Sixty-two patients who met the DSM-IV criteria for cyclothymic disorder and did not present comorbidity with other mood disorders, alcohol and drug abuse, and borderline personality disorder and 62 control subjects matched for sociodemographic variables were administered the Structured Interview for Diagnostic Criteria for Psychosomatic Research (DCPR), the Clinical Interview for Depression (CID) and the Mania Scale (MAS).
  
  
  RESULTS
  In DSM-IV terms, there was an overlap with anxiety disorders in more than half of the cases. About 3 patients out of 4 were found to present with at least one DCPR syndrome (particularly demoralization and irritable mood). Cyclothymic patients displayed significantly higher levels of depressive and anxiety disturbances on the CID, with particular reference to reactivity to social environment. They also had significantly higher scores on the MAS.
  
  
  CONCLUSIONS
  The study was cross-sectional and the sample, because of the exclusion criteria, may not be representative of the clinical populations in psychiatric settings.
  
  
  CONCLUSIONS
  In our patients with cyclothymia, without comorbidity with major mood disorders, DSM-IV anxiety disorders, psychosomatic clinical syndromes (irritable mood, demoralization) and subclinical symptoms such as reactivity to social environment resulted to be more frequent than in controls. The use of a broad assessment strategy aimed at subclinical symptomatology may help identifying clinical phenomena that cut across the current definition of subthreshold forms of bipolar disorder.
authors.affiliation: Affective Disorders Program, Department of Psychology, University of Bologna, Italy. elena.tomba@unibo.it
authors.forename: Elena
authors.initials: E
authors.lastname: Tomba
authors.forename: Chiara
authors.initials: C
authors.lastname: Rafanelli
authors.forename: Silvana
authors.initials: S
authors.lastname: Grandi
authors.forename: Jenny
authors.initials: J
authors.lastname: Guidi
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Fava
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis; D003430:Cross-Sectional Studies; D003527:Cyclothymic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000175:diagnosis