Prevalence of dysthymic disorder in primary care

Background: Dysthymic disorder is characterised as a chronic state of depre ssed mood which is not otherwise attributable to physical, psychological or social events. While it can occur alone, there is increasing evidence that the majority of individuals who meet criteria for dysthymic disorder also experience more severe episodic mood disorders throughout their lifetime, a nd there is also an aggregation of mood disorders within their family membe rs. Patients with dysthymic disorder are most often seen in primary care. S ome researchers suggest that the majority of these individuals are never di agnosed or are not diagnosed until a more severe episodic mood disorder dev elops. The objective of this study was to determine the 12-month prevalence of Axis I psychiatric disorders, and in particular dysthymic disorder, in a primary care Health Service Organization in Ontario, Canada. Methods: Eli gible and consenting adults registered with a primary care Health Service O rganization were screened using the modified form of the University of Mich igan Composite International Diagnostic Interview. Results: Of the 6280 eli gible subjects, 4327 (69%) consented to screening. Two hundred and twenty-t wo (5.1%) subjects screened positive for dysthymic disorder. In addition, 9 0% of those who screened positive for dysthymic disorder also screened posi tive for other Axis I disorders including major depressive disorder, panic, simple phobia, and generalized anxiety disorder. Conclusions: There is muc h potential for the primary care physician to play a pivotal role in the re cognition and treatment of dysthymic disorder and associated Axis I disorde rs. A focus on the family as a unit for care may be especially important gi ven the reported aggregation of dysthymic disorder within families. (C) 199 9 Elsevier Science B.V. All rights reserved.