distimia

Distimia, traditionally called dysthymia, is a chronic mood disorder characterized by depressed mood for most of the day and for more days than not, lasting for at least two years in adults (one year in children and adolescents). Under the DSM-5 classification, dysthymia is included in persistent depressive disorder (PDD), which encompasses chronic depressive symptoms with or without a major depressive episode.

Core symptoms include a persistently low mood and at least two of the following: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. Symptoms cause clinically significant distress or impairment and have not been due to another mental disorder, medical condition, or substance use. There may be periods of remission lasting only a few months, followed by relapse.

Prevalence is relatively common, and the condition tends to begin in adolescence or early adulthood, with a higher reported frequency in women. It often co-occurs with anxiety disorders and other mood disorders and can increase the risk of developing a major depressive episode.

Treatment combines psychotherapy and pharmacotherapy. Evidence supports cognitive-behavioral therapy and interpersonal therapy, alone or in combination with antidepressants such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or occasionally bupropion. Treatment duration is typically longer than for major depression, and improvement may be gradual. Ongoing management focuses on symptom monitoring, psychosocial functioning, and addressing comorbid conditions.