Persistent Depressive Disorder

At least two years of

depressive symptoms

Depressed mood most of the day on

more than 50% of days

No more than 2 months

symptom free

Symptoms can persist unchanged over

long periods (≥ 20 years)

May include periods of more severe

major depressive symptoms

Major depressive symptoms may be intermittent or

last for the majority or entirety of the time period

Types of PDD: Mild depressive symptoms without

any major depressive episodes (“with pure dysthymic syndrome”)

Types of PDD: Mild depressive symptoms with

additional major depressive episodes occurring intermittently (previously called “double depression”)

Types of PDD: Major depressive episode lasting

2+ years “with persistent major depressive episode”

PDD is also known as

dysthymia

DSM-5 Criteria: Depressed mood for most of the day, for more days than not, as indicated by

either subjective account or observation by others, for at least 2 years.

DSM-5 Criteria: In children and adolescents, mood can be

irritable and duration must be at least 1 year

DSM-5 Criteria: B. Presence, while depressed, of two (or more) of the following

1. Poor appetite or overeating
2. Insomnia or hypersomnia
3. Low energy or fatigue
4. Low self-esteem
5. Poor concentration or difficulty making decisions
6. Feelings of hopelessness

DSM-5 Criteria: During the 2-year period (1 year for children or adolescents) of the disturbance,

the person has never been without the symptoms in the aforementioned criteria for more than 2 months at a time.

DSM-5 Criteria: Criteria for major depressive disorder may be

continuously present for 2 years

DSM-5 Criteria: There has never been a

manic episode or a hypomanic episode and criteria have never been met for cyclothymic disorder.

DSM-5 Criteria: The disturbance is not better explained by a

persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

DSM-5 Criteria: The symptoms are not attributable to the

physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hypothyroidism).

DSM-5 Criteria: The symptoms cause clinically significant

distress or impairment in social, occupational, or other important areas of functioning.

Early onset:

If onset is before age 21 years

Late onset:

if onset is at age 21 years or older

With pure dysthymic syndrome:

if full criteria for a major depressive episode have not been met in at least the preceding 2 years.

With persistent major depressive episode:

if full criteria for a major depressive episode have been met throughout the preceding 2-year period

With intermittent major depressive episodes, with current episode:

if full criteria for a major depressive episode are currently met, but there have been periods of at least 8 weeks in at least the preceding 2 years with symptoms below the threshold for a full major depressive episode.

With intermittent major depressive episodes, without current episode:

if full criteria for a major depressive episode are not currently met, but there has been one or more major depressive episodes in at least the preceding 2 years