The essential feature of persistent depressive disorder (dysthymia) is a depressed mood
that occurs for most of the day, for more days than not, for at least 2 years, or at least 1 year
for children and adolescents (Criterion A). This disorder represents a consolidation of
DSM-IV-defined chronic major depressive disorder and dysthymic disorder. Major depression
may precede persistent depressive disorder, and major depressive episodes may
occur during persistent depressive disorder. Individuals whose symptoms meet major depressive
disorder criteria for 2 years should be given a diagnosis of persistent depressive
disorder as well as major depressive disorder.
Individuals with persistent depressive disorder describe their mood as sad or “down
in the dumps.” During periods of depressed mood, at least two of the six symptoms from
Criterion B are present. Because these symptoms have become a part of the individual’s
day-to-day experience, particularly in the case of early onset (e.g., “I’ve always been thisway”), they may not be reported unless the individual is directly prompted. During the 2-year
period (1 year for children or adolescents), any symptom-free intervals last no longer than
2 months (Criterion C).