THE CONCEPT OF DYSTHYMIA - AN OVERVIEW ON RECENT RESULTS AND ITS HISTORICAL BACKGROUND

The article reviews the historical development of the understanding of dysthymia from C. F. Flemming(1844) to DSM-IV and to Akiskal's concep ts. Recent results on epidemiology, comorbidity, neurobiology, familia l patterns, clinical course, psychological characteristics, psycho- an d pharmacotherapy of dysthymia are discussed. Although present concept s of dysthymia have led to results of high scientific and clinical rel evance, the classification of chronic depressions and their relation t o both personality disorders and affective psychoses need further clar ification. The development of dysthymia reflects the differences betwe en Anglo-American operational psychiatric systems and the rich traditi on of psychopathology in German-speaking psychiatry.