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Definition And Core Criteria
- Persistent depressive disorder is defined by depressive symptoms present most days for 2+ years (1 year in children/adolescents).
- It requires two or more specific symptoms and exclusion of bipolar or psychotic disorders.
Screen For Chronicity, Not Just Severity
- Screen for chronicity by asking patients whether they feel 'always depressed' or by noting long-term subthreshold PHQ-9 scores.
- Ask specifically about duration and persistence to distinguish from episodic major depression.
DSM-5 Consolidation Explained
- DSM-5 (2013) consolidated dysthymic disorder and chronic major depression under persistent depressive disorder.
- The subtypes share similar courses and likely represent manifestations of the same underlying condition.