DSM-5 Diagnostic Criteria
Persistent depressive disorder (dysthymia) 300.4 (F34.1)
This disorder includes chronic major depressive disorder and DSM-IV dysthymic disorder.
A. Depressed mood for most of the day, present on more days than absent, as indicated by subjective information or observation by others, for at least two years.
Note: In children and adolescents, the mood may be irritable and the duration must be at least one year.
B. Presence, during depression, of two (or more) of the following symptoms:
1. Little appetite or overeating.
2. Insomnia or hypersomnia.
3. Low energy or fatigue.
4. Low self-esteem.
5. Lack of concentration or difficulty making decisions.
6. Feelings of hopelessness.
C. During the two-year period (one year in children and adolescents) of the disturbance, the individual has never been without the symptoms of Criteria A and B for more than two months in a row.
D. The criteria for a major depressive disorder may be continuously present for two years.
E. There has never been a manic episode or a hypomanic episode, and the criteria for cyclothymic disorder have never been met.
F. The disturbance is not better explained by persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum disorder and other psychotic disorder.
G. Symptoms cannot be attributed to the physiological effects of a substance (e.g., drug, medication) or to another medical condition (e.g., hypothyroidism).
H. Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Note: Because the criteria for a major depressive episode include four symptoms that are not on the persistent depressive disorder symptom list
will have depressive symptoms that have persisted for more than two years but will not meet criteria for persistent depressive disorder. If at any time during the current illness episode all criteria for a major depressive episode have been met, a diagnosis of major depressive disorder will be made. If not, a diagnosis of other specified depressive disorder or unspecified depressive disorder is warranted.
Specify if:
Anxiously
With mixed characteristics
With melancholic characteristics
With atypical characteristics
With psychotic characteristics consistent with mood
With psychotic characteristics not consistent with mood
With onset in the peripartum
Specify if:
In partial remission
In total remission
Specify if:
Early onset: If the onset is before age 21.
Late start: If the start is after 21 years of age.
Specify if (during most of the most recent two years of persistent depressive disorder):
With pure dysthymic syndrome: All criteria for a major depressive episode have not been met in at least the previous two years.
With persistent major depressive episode: All criteria for a major depressive episode have been met during the previous two years.
With intermittent episodes of major depression, with current episode: All criteria for a major depressive episode are currently met, but there have been periods of at least 8 weeks in at least the previous two years with symptoms below the threshold for an episode of complete major depression.
With intermittent episodes of major depression, no current episode: Not all criteria for a major depressive episode are currently met, but there have been one or more episodes of major depression at least in the previous two years.
Specify the current severity:
Mild
Moderate
Serious