Persistent depressive disorder - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Persistent depressive disorder includes common forms of depression, but lasting longer than acute major depressive disorder.
Frequently misdiagnosed because the correct criteria to diagnose this condition are often not applied. Affected patients have a depressed mood most of the day, for more days than not, for at least 2 years. While depressed, patients have at least 2 of: poor appetite/overeating, insomnia or hypersomnia, low energy/fatigue, low self-esteem, poor concentration or difficulty making decisions, or feelings of hopelessness. Symptoms do not remit for more than 2 months at a time.
Associated with significant functional impairment (including unemployment, difficulty establishing intimate relationships, greater healthcare utilization, greater utilization of public entitlements).
Patients may respond to pharmacotherapy, psychotherapy, or a combination of both.
Patients require a longer treatment period, more psychotherapy sessions, and/or higher doses of antidepressant medication compared with patients with acute forms of depression.

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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
Blanco C, Okuda M, Markowitz JC, et al. The epidemiology of chronic major depressive disorder and dysthymic disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2010 Dec;71(12):1645-56.[Abstract][Full Text]
Devanand DP, Adorno E, Cheng J, et al. Late onset dysthymic disorder and major depression differ from early onset dysthymic disorder and major depression in elderly outpatients. J Affect Disord. 2004 Mar;78(3):259-67.[Abstract]
Levkovitz Y, Tedeschini E, Papakostas GI. Efficacy of antidepressants for dysthymia: A meta-analysis of placebo-controlled randomized trials. J Clin Psych. 2011 Apr;72(4):509-14.[Abstract]
Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007 Apr 18;297(15):1683-96.[Abstract]
Pedrelli P, Iovieno N, Vitali M, et al. Treatment of major depressive disorder and dysthymic disorder with antidepressants in patients with comorbid opiate use disorders enrolled in methadone maintenance therapy: a meta-analysis. J Clin Psychopharmacol. 2011 Oct;31(5):582-6.[Abstract]
Bauer M, Severus E, Köhler S, et al; World Federation of Societies of Biological Psychiatry Task Force on Unipolar Depressive Disorders. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 2: maintenance treatment of major depressive disorder - update 2015. World J Biol Psychiatry. 2015 Feb;16(2):76-95.[Abstract][Full Text]

Other Online Resources

Patient Health Questionnaire (PHQ-9)
Beck Depression Inventory (BDI)
Quick Inventory of Depressive Symptoms (QIDS)

Referenced Articles

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