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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index




Minerva Psichiatrica 2011 September;52(3):125-44

language: English

Dysthymic disorder reviewed: treating chronic depression in the age of DSM-5

Hellerstein D. J.

College of Physicians and Surgeons of Columbia University, Research Psychiatrist, New York State Psychiatric Institute, New York, NY, USA


Dysthymic disorder, a form of low-grade chronic depression, has been studied over the past three decades. A variety of forms of research, from epidemiological research to psychopharmacology and psychotherapy outcome studies, has provided data that may help clinicians who treat patients with dysthymic disorder and other forms of chronic depression. This article reviews clinically relevant research studies and applies their findings to the clinical setting. Epidemiological research and prospective follow-up studies haved defined the risks of untreated chronic depression, and have demonstrated that the various forms of chronic depression (including but not limited to dysthymic disorder, chronic major depression, and residual major depression) have a similar course and outcome. Studies of dysthymic disorder, including psychopharmacology and psychotherapy outcome studies as well as biological research, have demonstrated that chronicity is at least as important a determinant of outcome as cross-sectional severity. Hence the DSM-5 Mood Disorders Work Group has proposed a new category of Chronic Depressive Disorder (CDD) which will include these various forms of chronic depression. Furthermore, emerging neuroscience research on positive and negative neuroplasticity supports the importance of attaining sustained remission and the possibility of recovery of normal psychosocial functioning. Consequently, psychiatric clinicians have a significantly greater chance of helping patients with dysthymic disorder and other forms of chronic depression now than only 30 years ago.

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