Our expert says:
Hello there, Piqued Wooman ! I know Tchaikowsky wrote an Opera called Pique Dame, but I doubt he was thinking of you rather than playing cards.
Notice I suggested it was relatively rare for young children to be DIAGNOSED as depressed. It is surely more common than gets diagnsed. Your son's story is uncommon and complex. Rheumatic fever is fortunately not as common as it once was, and Sydenham's Chorea also uncommon - we learn about it in medical school, but many doctors will not see a case. One wonders what medications he received for the rheumatic fever ( even antibiotics can cause psychotic reactions AND depressions, more than most docs realize ) and what meds for the Chorea.
There's a possibility they might have singly or in combination, contributed to the psychotic episode, and/or the depression.
Anyhow, Dysthymia is a relatively new concept ( of course, it needs a really old guy like me to see something that's been around for a decade or so, as "relatively recent" ! )- but it's not a mainstream. widely recognized disorder. I don't regularly hunt through the specialized child psychiatry literature, but I haven't come across good research into this condition, its treatment and especially the outcomes.
Someone would need to study a realy large number of kids with any such disorder to answer even a fairly simple question like "at what age does it usually start ?" I know of no reason to expect it to develop into Bipolar Disorder or major depression later in life, though it may increase slightly the risk of this. Many people have Dysthymia ( sometimes described as depression spread thin - never quite as severe as major Depression, but lasting longer ) for decades, without deveooping Bipolar Disorder, or even a major depression.
Its frustrating when there are questions like these and don't have the right research to answer them. Without research, a doc can only guess on the basis of his own knowledge and experience. But the right sort of research, involving many children and following them up over years, is very expensive, not usually funded by governments, and not receiving drug company research funds either.
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