Persistent Depressive Disorder
Persistent Depressive Disorder
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(Dysthymia)
Prevalence
Prevalence
The 12-month prevalence in the United States is approximately 0.5% for persistent depressive disorder and 1.5% for chronic major depressive disorder.
Risk factors
Risk factors
Temperamental
Temperamental
Higher levels of neuroticism (negative affectivity).
Poorer global functioning.
Presence of anxiety disorders or conduct disorder.
Environmental
Environmental
Childhood risk factors include parental loss or separation.
Genetic and physiological
Genetic and physiological
It is likely that individuals with persistent depressive disorder will have a higher proportion of first-degree relatives with persistent depressive disorder than do individuals with major depressive disorder, and more depressive disorders in general.
A number of brain regions (e.g., prefrontal cortex, anterior cingulate, amygdala, hippocampus) have been implicated in persistent depressive disorder.
Possible sleep abnormalities exist as well.
Symptoms
Symptoms
Depressed mood for most of the day, for more days than not, for at least 2 years.
Presence, while depressed, of two (or more) of the following:
Poor appetite or overeating.
Insomnia or hypersomnia.
Low energy or fatigue.
Low self-esteem.
Poor concentration or difficulty making decisions.
Feelings of hopelessness.
There has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder.
The disturbance is not better explained by another psychotic disorder.
The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g. hypothyroidism).
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
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