dysthymia

Dysthymia, now referred to as persistent depressive disorder (PDD) in the DSM-5-TR, is a mood disorder defined by a chronically depressed mood. In adults, the mood must be present for most days for at least two years (one year for children or adolescents), with symptoms persisting most of the day for a majority of days. Along with the depressed mood, individuals typically have two or more symptoms such as poor appetite or overeating, insomnia or hypersomnia, low energy, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. During the two-year period, the person should not be without symptoms for more than two consecutive months.

Dysthymia is usually milder in intensity than major depressive disorder but is more persistent. It can occur alone or be accompanied by major depressive episodes, a pattern known as double depression. The coexistence of a major depressive episode within persistent depressive disorder affects prognosis and treatment planning.

Etiology is multifactorial, involving genetic vulnerability, neurobiological factors, and psychosocial stressors. Early life adversity, chronic stress, and coexisting psychiatric conditions, particularly anxiety disorders, increase risk. The course is often chronic and 기능ally impairing, with episodes of higher severity possible.

Diagnosis is clinical, based on DSM-5-TR criteria after ruling out medical conditions and substance effects. Treatment typically includes psychotherapy (such as cognitive-behavioral therapy or interpersonal therapy) and pharmacotherapy (for example, SSRIs or SNRIs), with some patients benefiting from a combination or long-term management. Lifestyle interventions, regular sleep, and physical activity can support recovery and reduce relapse.

Prognosis varies; many individuals improve with treatment but the condition can be persistent. Lifetime prevalence in adults is estimated to be a few percent, and PDD is often underdiagnosed.