What causes persistent depressive disorder (dysthymia)?

Updated: Oct 01, 2019
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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The cause of dysthymia, although not clear, is likely multifactorial. A biopsychosocial formulation considering the interplay of family history and other genetic factors, medical problems, psychological make-up and coping strategies, and social stressors is helpful when considering the cause of dysthymia. Some examples of common contributing factors include the following:

  • Genetic predisposition

  • Biological factors - such as alterations in neurotransmitters, endocrine, or inflammatory mediators

  • Chronic stress - particularly with feelings of hopelessness and/or helplessness

  • Chronic medical illness

  • Psychosocial factors - such as social isolation, losses

  • Ruminative coping strategies - these, as opposed to problem-solving or cognitive-restructuring strategies, are common among people with dysthymia and may predispose to or sustain dysthymia [6]

  • Antisocial, borderline, dependent, depressive, histrionic, or schizotypal personality traits - people diagnosed with these are at an increased risk for developing dysthymic disorder [7, 8]

Electroencephalogram (EEG) and polysomnogram data demonstrate that about 25% of people who have dysthymia have sleep changes similar to those of persons who have major depression, including shortened rapid eye movement (REM) latency, increased REM density, and poor sleep continuity.

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