Persistent Depressive Disorder (Dysthymia)

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Persistent depressive disorder (formerly known as "dysthymia") is a chronic mood disorder that presents as depression but is both less severe and longer-lasting.

The DSM-5 renamed dysthymia to persistent depressive disorder (PDD), combining it with chronic major depressive disorder because it was determined that there was little difference between the two diagnoses.

PDD is described as a serious state of chronic depression, which persists at least two years (one year for children and adolescents), and is both less acute and less severe than major depressive disorder. PDD symptoms that begin before age 21 are diagnosed as "early onset PDD", while symptoms appearing after that are called "late onset PDD."

Because the symptoms of PDD are longer lasting and less intense, it is possible that some sufferers will experience symptoms for many years before being diagnosed, if, in fact, they ever receive a diagnosis. For some, the symptoms have been with them so long that they have come to feel that they are intrinsic to their lives and personalities. These individuals may see themselves to be naturally gloomy, tired for reasons that are physical and not emotional, and with introverted rather than outgoing personality.

The causes of PDD are no better known than the causes of depression. Genetics may well play a role, as PDD can appear multiple times within a family. Chemical imbalances within the brain may possibly cause PDD. PDD may also be triggered by environmental factors, such a loss of a loved one, loss of a job or serious financial difficulties.

PDD typically has an early onset in children, adolescents or young adults. Children who suffer from PDD will exhibit impaired performance in school and impaired social interaction. Older children and adolescents will appear to lack self-esteem, have poor social skills and a persistently negative emotional outlook. Those who develop PDD before age 21 are generally given a poorer prognosis than those who develop PDD later in life.

Children with PDD who do not get treatment are at increased risk for developing any of an array of personality disorders, including Borderline PD, Narcissistic PD, Antisocial PD, Obsessive Compulsive Disorder and others.

Adults with PDD who do not receive treatment have a 75% likelihood of developing a major depressive disorder within five years. PDD is generally comorbid with major psychiatric disorders and specifically comorbid for anxiety disorders and substance abuse disorders.

A combination of both medication and psychotherapy (cognitive behavioral therapy, specifically) has been found to be the most effective treatment for PDD. If medications are given alone, they are more effective than psychotherapy alone. SSRIs are generally prescribed as treatment.

Sources: MedicineNet , and Mayo Clinic


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