Table : TABLE 5.4 • DSM-5 Diagnostic Criteria for Persistent Depressive Disorder (Dysthymia)
  1. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.
    Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.
  2. Presence, while depressed, of two (or more) of the following:
    1. Poor appetite or overeating.
    2. Insomnia or hypersomnia.
    3. Low energy or fatigue.
    4. Low self-esteem.
    5. Poor concentration or difficulty making decisions.
    6. Feelings of hopelessness.
  3. During the 2-year period (1 year for children and adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time.
  4. Criteria for a major depressive disorder may be continuously present for 2 years.
  5. There has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder.
  6. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
  7. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hypothyroidism).
  8. The symptoms cause clinically significant distress of impairment in social, occupational or other important areas of functioning.
Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright ©2013). American Psychiatric Association. All Rights Reserved.