Psychological medicine

Dysthymic Disorder

  • Diagnostic criteria:
    • Depressed mood for most of the day, for more days than not, for at least 2 years
    • Other depressive symptoms 
    • But not a major depressive episode, no manic, hypomanic or psychotic features, no substance abuse or GMC
  • Differential from Major Depressive Disorder:
  1. Difficult as differences in onset, duration, persistence and severity are not easy to retrospectively evaluate
  2. Major depression often has a more marked contrast from normal. In dysthymic disorder, low mood is less easily distinguished from person‟s normal function.
  • If major depressive episode on top of existing dysthymic disorder, then may recover more quickly than normal from the major depression, but are at significantly higher risk of relapse with faster cycles
  • Treatment: antidepressants for up to three years together with appropriate life skills training and psychological therapy