*DSM-Persistent Depressive Disorder (PDD)

Persistent Depressive Disorder (PDD), noted in the DSM-5, is characterized by a chronically depressed mood.

Diagnostic Criteria for PDD

  1. Criterion A: Depressed Mood
    Individual experiences a depressed mood for most of the day, for more days than not. Duration must be at least 2 years (or 1 year for children and adolescents). Mood may be described as irritable in children and adolescents.

  2. Criterion B: Presence of Additional Symptoms
    While the individual is experiencing depressive mood, 2 or more of the following symptoms should be present:

    • Poor appetite or overeating.

    • Insomnia or hypersomnia.

    • Low energy or fatigue.

    • Low self-esteem.

    • Poor concentration or difficulty making decisions.

    • Feelings of hopelessness.

  3. Criterion C: Duration of Symptoms
    Throughout the 2-year period (or 1 year for children and adolescents), the individual has never been without the symptoms described in Criterion A and B for more than 2 months at a time.

  4. Criterion D: Major Depressive Disorder (MDD) Criteria
    Criteria for Major Depressive Disorder (MDD) may be present for 2 years.

  5. Criterion E: Absence of Manic or Hypomanic Episodes
    The individual has never experienced a manic or hypomanic episode.

  6. Criterion F: Exclusion Criteria
    The disturbance cannot be better explained by a schizophrenia spectrum or other psychotic disorder.

  7. Criterion G: Not Attributed to Substance or Medical Condition
    The symptoms are not caused by a substance (e.g., drug abuse, medication) or a medical condition (e.g., thyroid issues).

  8. Criterion H: Clinical Distress/Impairment
    Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Additional Specifiers

  • Early Onset: Before 21 years of age.

  • Late Onset: At or after 21 years of age.

  • Pure Dysthymic Disorder or PDD Episode
    Concept of Double Depression: Some patients may develop MDD while diagnosed with PDD and then revert back to PDD, which is referred to as Double Depression. Notably, approximately 22% of patients with PDD experience this progression into MDD.