Dysthymia

C.F. Flemming first used Dysthymia (from the Greek abnormal mood) in psychiatry in 1844. In 1882 K.L Kahlbaum used the term Dysthymia to describe a predominantly depressive temperament that with Cyclothymia and Hyperthymia, belonged to subthreshold manifestation of Manic-Depressive Psychosis.

E. Kraepelin, in his conceptualization of Manic-Depressive Insanity preferred the term depressive temperament, a “…permanent gloomy emotional stress in all the experience of life.”

More recently, introduced in the DSM III (1980) as a diagnostic category for mild to moderate forms of chronic depression. Dysthymic Disorder has substituted previous categories such as Neurotic Depression and Depressive Personality Disorder. Criteria for Dysthymia can be viewed here (Link).

When a depressive syndrome is superimposed on a dysthymic disorder the term ‘Double Depression’ is used. The return to a dysthymic baseline after recovery from an episode of full-blown Depression is often referred to as ‘partial remission’.

Dysthymia affects about 3% of the population, runs in families and has an early age of onset. In spite of its mild symptoms, Dysthymia causes significant disability. It is a risk factor for the development of Depression and responds to antidepressant treatment. Its relationship with MDI remains unclear. A study by Klein and colleagues showed an increased frequency of antidepressant-induced Hypomania among patients treated for Double Depression.

It has been hypothesized that a dysthymic temperament occurs frequently among patients who suffer from Mania, and might lead to the development of mixed manic or dysphoric states.