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Full description of Dysthymia. Definition, signs, symptoms, and causes of Dysthymia.

Description of Dysthymia

Full description of Dysthymia. Definition, signs, symptoms, and causes of Dysthymia.Dysthymia is a chronic form of depression, but is milder in severity than major depression. People who suffer from dysthymia have a persistent underlying depression.

Dysthymia (dysthymic disorder) usually sets in during early adulthood, and the disorder can last for years or even decades. Later onset is usually associated with bereavement or obvious stress, and often follows on the heels of a more extreme depressive episode. Women are twice as likely as men to suffer from dysthymia, similar to that seen with major depression. About 3% of the population is affected by dysthymic disorder, with three-quarters of individuals displaying signs of other psychiatric or medical disorders as well.

Diagnostic Criteria for Dysthymia

A. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.

B. Presence, while depressed, of two (or more) of the following:

  1. poor appetite or overeating
  2. insomnia or hypersomnia
  3. low energy or fatigue
  4. low self-esteem
  5. poor concentration or difficulty making decisions
  6. feelings of hopelessness

C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in Criteria A and B for more than 2 months at a time.


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D. No Major Depressive Episode has been present during the first 2 years of the disturbance (1 year for children and adolescents); i.e., the disturbance is not better accounted for by chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission.
Note: There may have been a previous Major Depressive Episode provided there was a full remission (no significant signs or symptoms for 2 months) before development of the Dysthymic Disorder. In addition, after the initial 2 years (1 year in children or adolescents) of Dysthymic Disorder, there may be superimposed episodes of Major Depressive Disorder, in which case both diagnoses may be given when the criteria are met for a Major Depressive Episode.

E. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder.

F. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophrenia or Delusional Disorder.

G. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Early Onset: if onset is before age 21 years. This may increase the likelihood of developing later major depressive episodes.

Late Onset: if onset is age 21 years or older

Specify (for most recent 2 years of Dysthymic Disorder):

With Atypical Features

Also known as: depressive neurosis, depressive reaction, neurotic depression

Causes of Dysthymia

Researchers aren't sure what causes dysthymia, but it seems to be related to the brain chemical, serotonin, which helps the brain cope with emotions. Major life stressors, chronic illness, medications, and relationship or work problems may also increase the chances of dysthymia.

Genetics-heredity may also play a role in the development of dysthymia. Most people with dysthymia will have a family history of mood or affective disorders

Although it can occur at any age, dysthymia often begins earlier than major depression - in childhood, adolescence, or early adult life. Because of its usually early occurrence and its chronic nature, dysthymia seems to become embedded in a person's personality and to appear like a personality trait. People who have dysthymia have been thought to have a "depressive personality" or "depressive neurosis."

For comprehensive information on dysthymia and other forms of depression, visit the HealthyPlace.com Depression Community.

Sources: 1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association. 2. Merck Manual, Home Edition for Patients and Caregivers, last revised 2006.

back to: Psychiatric Disorders Definitions Index

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