DYSTHYMIC DISORDER - THE CHRONIC DEPRESSION

Dysthymic disorder is defined as chronic depression of a mild to moder ate degree for at least two years' duration. The disorder tends to be underdiagnosed despite a prevalence of 5 to 15 percent in primary care settings. Both the diagnosis and treatment of dysthymic disorder may be complicated by a variety of comorbid psychiatric and medical condit ions as well as chronic stressors. Treatment may be determined by the accompanying comorbid condition. Antidepressant drugs are moderately e fficacious in the treatment of dysthymia, with selective serotonin reu ptake inhibitors preferred over tricyclic antidepressants. However, pa tients may report oversensitivity to antidepressants, experience only partial remission with treatment and suffer relapses. Adjunctive suppo rt or psychodynamic psychotherapy should also be considered.