Dysthymia

Dysthymia ( dihss-THY-mee-ə), known as persistent depressive disorder (PDD) in the DSM-5-TR and dysthymic disorder in ICD-11, is a psychiatric condition marked by symptoms that are similar to those of major depressive disorder, but which persist for at least two years in adults and one year among children. The term was introduced by Robert Spitzer in the late 1970s as a replacement for the concept of "depressive personality".

With the DSM-5's publication in 2013, the condition assumed its current name (i.e., PDD), having been called dysthymic disorder in the DSM's previous edition (DSM-IV), and remaining so in ICD-11. PDD is defined by a two-year history of symptoms of major depression not better explained by another health condition, as well as significant distress or functional impairment.

Individuals with PDD, defined in part by its chronicity, may experience symptoms for years before receiving a diagnosis, if one is received at all. Consequently, they might perceive their dysphoria as a character or personality trait rather than a distinct medical condition and never discuss their symptoms with healthcare providers. PDD subsumed prior DSM editions' diagnoses of chronic major depressive disorder and dysthymic disorder. The change arose from a continuing lack of evidence of a clinically meaningful distinction between chronic major depression and dysthymic disorder.

Signs and symptoms

Dysthymia is characterized by a two-year history of depressed mood, as well as at least two of the following symptoms: poor appetite or overeating, hypersomnia or insomnia, fatigue or low energy, low self-esteem, poor concentration or difficulty making decisions, and hopelessness. Irritability, rather than sadness, may predominate in the pediatric setting.