DYSTHYMIA IN CLINICAL-PRACTICE

Background. Dysthymia has been reconceptualised in recent years from a personality disorder to a chronic affective disorder. It is incorpora ted into both the DSM and ICD diagnostic systems. Method. The members of the WPA Dysthymia Working Group combined the results of their manua l literature searches with a search using Medline. Results. Available data are summarised under the headings of classification, epidemiology , validity, comorbidity, course and outcome, pharmacotherapy and psych otherapy. The coexistence of major depressive disorder, constituting ' double depression' is of particular importance. Conclusions. Improved knowledge of this disorder has led to a more positive approach to trea tment, in which antidepressants can usefully be complemented by psycho social measures. A high proportion of cases remain unrecognised in mos t populations, leading to prolonged morbidity and distress, much of wh ich is now treatable.