Persistent Depressive Disorder (Dysthymia and Chronic Depression)

Question 1

DSM Criteria

Answer 1

1. Depressed mood for most the day, for more days the not, as indicated by subjective account or observation by others for AT LEAST 2 YEARS
2. Presence, while depressed, of at least two or more of the following: poor appetite or overeating; insomnia or hypersomnia; low energy; low self-esteem; poor concentration or difficulty making decisions; feelings of hopelessness
3. During the 2 year period (1 for teens and kids) of disturbance, the individual has never been without the symptoms in Criteria 1 or 2 for more then 2 months at a time.
4. criteria for a major depressive disorder may be continuously present for 2 years
5. never been a manic or hypomanic episode and criteria have never been met for cyclothymic disorder
6. no better explained by a schizoaffective disorder
7. symptoms are not linked to substances or medical issues
8. cause significant distress

Question 2

How long does one have the symptoms? (adults)

Answer 2

2 years, at least!

Question 3

MDD vs Dysthymic

Answer 3

dysthymic persons has greater co-morbidity, have lower self-esteem and greater suicidality; also report more maladaptive parenting

Question 4

Comorbidity

Answer 4

60% of patients meet criteria for a personalty disorder; most frequent being avoidant, borderline and dependent personality disorders

Question 5

How long does on have the symptoms? (Teens and kiddos)

Answer 5

1 year! and you can swap irritability for depressed mood

Question 6

assessment

Answer 6

Extremely difficult to assess as the client can find these symptoms as a normal part of life AND therapists focus on acute diagnoses more (pg 349 of text)

Question 7

Treatment

Answer 7

may require longer pharmacotherapy and may be more likely then MDD to benefit from BOTH medications AND therapy