What are the DSM-5 criteria for persistent depressive disorder (dysthymia)?

Updated: Oct 01, 2019
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

The specific DSM-5 criteria for persistent depressive disorder (dysthymia) are as follows: [1]

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

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 and/or difficulty making decisions

  • Feelings of hopelessness

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

Criteria for major depressive disorder may be continuously present for 2 years.

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 a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorders.

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.

As with other depressive disorders, persistent depressive disorder (dysthymia) can be given further specifiers:

  • With anxious distress

  • With mixed features

  • With melancholic features

  • With atypical features

  • With mood-congruent psychotic features

  • With mood-incongruent psychotic features

  • With peripartum onset


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