DDysthymic Disorder: Who Cares?

Dysthymic disorder, or low-grade chronic depression, is a paradoxical condition.  It is common, seen among 3 to 5% of the general population. On a day to day basis it is a mild condition, but in the words of one researcher, on a long-term basis, "it is severe."  When followed over time, people with dysthymic disorder actually have higher risks of suicide attempts, psychiatric hospitalizations, and other poor outcomes than individuals who present with episodes of more severe 'major' depression.  Not only that, a person who has dysthymic disorder is at very high risk of developing more severe episodes of depression: in one study, over 3/4 of dysthymics developed major depression within five years. 

Dysthymic disorder has been in general neglected; in the entire world literature there are fewer than 20 published double-blind placebo controlled studies of treatment for DD.  Nevertheless, a number of medication and psychotherapy approaches have been found to be successful, at least in short-term treatment.  There is a need for more research in order to better understand how to treat dysthymic disorder, why it occurs, and how to prevent the progression to major depression. Beyond that there is a need for significant progress in basic neurobiological studies to understand the causes of this disorder.

Of note, the DSM-5 has recategorized dysthymic disorder within a new category of Persistent Depressive Disorder (PDD), which also includes chronic major depression and other forms of chronic depression. The reason for this recategorization is that studies have indicated that the different forms of chronic depression have much in common, in their effects on people's lives, in their genetics and neurobiology and response to treatment. All forms of PDD are associated with significant impairment in quality of life, work productivity, and a wide range of health outcomes.

Recommended Links

More About Dysthymic Disorder (Chronic low-grade Depression):

About  Major Depression and the new DSM-5 Category of Persistent Depressive Disorder:

Affiliated with the Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute



The New York State Psychiatric Institute

Columbia University Department of Psychiatry 
Specializing in Treatment and Research

of Chronic Depression

   Mood Disorders Research Program/

      Depression Evaluation Service

   1775 Broadway , Suite #1403   (57th St)

   New York, NY 10019

   Tel. 646-774-8000

   Email. desdesk@nyspi.columbia.edu