A Case Report on Persistent Depressive Disorder

Usefulness of individualized homoeopathic medicine in Persistent Depressive Disorder  (Dysthymic disorder). 

INTRODUCTION 

Persistent depressive disorder (formerly dysthymic disorder) is characterized by chronic low-level depression that is not as severe, but may be longer lasting than, major depressive disorder. A diagnosis of persistent depressive disorder requires having experienced a combination of depressive symptoms for at least 2 years.  Globally dysthymia occurs in about 105 million people a year (1.5% of the population). It is slightly more common in women (1.8%) than in men (1.3%). The lifetime prevalence rate of dysthymia in community settings appears to range from 3 to 6% in the India. Depression is one of the common complaints for psychiatric consultancy to a Homoeopath. This aims to assess the effectiveness and safety of homoeopathy in Depression.      

A CASE REPORT

Preliminary data

Date – 19/12/2022 

Registration-no.- 66390 

Patient Name- Mr. R.B 

Age/ Sex- 21/M 

Socio-economic status- Middle class 

Occupation- GNM Student 

Religious/ Nationality- Hindu/ Indian 

Hometown Address- Delhi ( Panjabi bagh) 

Dietry Habit- Veg 

Chief Complaints 

LOCATION	SENSATION	MODALITIES	CONCOMITANTS
MINDSudden  D-June 2020P-Progressive	Homesickness+3Lack of confidence+3Lack of interest+3-Excessive thoughts+3Worried about family+3Low mood+3	< AloneCompany

Physical Generals 

Appearance	Wheatish complexion, average height,smiling face	Perspiration	Normal, more on back, smelly
Appetite	3 meals/Day	Tongue	–
Thirst	2-3 Glass/ Day	Sleep	Sound sleep
Desire	Cold water	Dream	–
Aversion	–	Thermal	Towards Hot
Craving	Sweet+3	Bathing habit	Regular
Stool	1 time/ Day,Satisfactory	Sexualfunction	–
Urine	Clear, D4-5, N0-1	Menstrualfunction	–
Any food/ medicine allergy/ drug history	N.S

Parents/Mother’s  Obstetrics History

NS

Developmental Landmarks

Milestones On Time

Past History

NS

Family History

Father- Accidental, HTN 

Mother- OA, DM, Heart Attack

Life Space

A wheatish complexion, smiling face , 22 years male patient came to the OPD. He was born & brought up at Delhi.

His family consists of   Mother, Father and 3 Sibling (Sisters).He told that he was shy and average in study during childhood.

He scored 80% in 12^th and moved Jaipur in June 2021. Normally, family environment is good but he is not allowed to go outside after 8pm.

His father is strict in nature. He likes to stay at home but his parents don’t allow him to stay there (Hometown). Socially he is very active and has many friends and easily mixes up with people.

He had relationship of 5 years but got breakup because that girl got married.

There is disappointment of love. Patient has the fear of father but still wants to go back to the home and help his parents.

He told that his anger is violent and become abusive during anger that is why  his father does not want him to stay at home. He is still angry with his ex girlfriend and wants to take revenge from her but did not do anything with her.

His emotions are suppressed and does not want to share his things with anyone.

Responsible in nature.

Diagnosis 

 Persistent Depressive Disorder  (Dysthymic disorder)

Analysis and Evaluation of Symptoms 

Mental Symptoms	Physical Symptoms	Particular Symptoms
HomesicknessLack of interestLack of concentrationLow mood Excessive thoughtsEmotions suppressed< Alone> CompanyA/F Disappointed love Fear of being cheated	Desire- sweetDesire- cold waterDesire- warm foodPerspiration – smelly	–

Totality Of Symptoms 

1. A/F Disappointed love
2. < Alone
3. > Company
4. Homesickness
5. Low mood
6. Emotions suppressed
7. Desire for sweet
8. Desire for warm food
9. Perspiration smelly

Repertorial Totality 

1.  MIND- Ailments from; love disappointment
2.  MIND- Company- Desire for – alone aggravation; when
3.  MIND- Emotions- suppressed
4.  MIND- Homesickness
5.  MIND- Morose
6.  GENERAL- FOOD & DRINK- sweet- desire
7.  GENERAL- FOOD & DRINK- Warm food- desire

Repertorial Result

1.  Nat. Mur 6/11
2.  Phosphorus 6/11
3.  Calcarea 6/10
4.  Causticum 6/10
5.  Ignatia 5/12
6.  Phos. Acid 5/11
7.  Lyco 5/10

Prescription 

After Repertorization, Here, Phosphorus was selected on the basis of constitution of  the patient.  

Phosphorus 1M/ Stat/ 1 dose  

was given to the patient on 19^th December 2022.   

Follow ups 

Date	Remedyresponse	Interpretation	Prescription	Reason	Expectation
3/2/2023	Homesickness-	Better	Rx	Need to	There
	controlled		1. Phosphor	repeat the	should be
	Lack of		us 1M/ 1	dose for	relieve
	confidence-		Dose/ Stat	better
	20% ↓		2. Saclac	improvement
	Low mood-		200// OD X
	20% ↓		15 Days
27/2/2023	Feeling better-	Better	Rx	Medicine	Symptoms
	40% ↓		1. Saclac	responding	should be
	Homesickness-		200/ 1 Dose/	well, need to	relieved
	Absent		Stat	wait & watch
	Lack of		X 15 Days
	confidence-
	40% ↓
	Low mood-
	50% ↓
27/3/2023	Feeling better-	Better	Rx	Medicine	Symptom
	80% ↓		1. Saclac	responding	Can be
	Homesickness-		200/ 1 Dose/	well, need to	constant
	Absent		Stat	wait & watch
	Lack of		X 15 Days
	confidence-
	80% ↓
	Low mood-
	80% ↓
	All PG-
	normal
21/4/2023	All the	Improved	Rx	Improved ,	Old
	complaints –		Saclac	no need to	symptoms
	Absent		200/ 1 Dose/	give	can be
	No new		Stat	medicine,	reappear
	symptoms		X 15 Days	only for
	All PG-			mental
	Normal			satisfaction
				of the patient

5/5/2023	Lack of concentration Low mood Excessive thoughts Homesickness	Old symptoms reappear	Rx 1.Phosphorus 1M/ 1 Dose/ Stat	Need to repeat the medicine	There should be relief
12/5/2023	Lack of concentration- SQLow mood – SQExcessive thoughts- SQ Homesickness- SQ	No change	RxThuja 1M/ Stat.Phosphor us 1M/ 1 Dose/ HSX 15 Days	Need to give Intercurrent medicine	There should be relief

Discussion 

Patient came to the OPD with the symptoms of Persistent Depressive Disorder. Phosphorus 1M was given to him on the basis of his constitution. There was relief in the the symptoms. Two scales were applied in the patient. First one was the PSS Scale (Perceived Stress Scale)  which was used during screening with the score of 22 and SSI (Student Stress Inventory ) was the Second scale which  was applied pre and post treatment. There was changes in the score, pre score was 71 and post treatment was 51.