Persistent Depressive Disorder (PDD) is a mood disorder characterized by a depressed mood that occurs for most of the day, for more days than not, for at least two years (one year for children and adolescents). PDD is a consolidation of DSM-IV diagnosis of chronic major depressive disorder and dysthymic disorder.
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.
1
year.
Presence, while depressed, of at least 2
of the following:
HE'S 2 SAD
can be used to remember the criteria for persistent depressive disorder (dysthymia in DSM-IV).H
- HopelessnessE
- Energy lowS
- Self-esteem2
- 2 years of symptomsS
- Sleep decreasedA
- Appetite poorD
- Difficulty making decisions
The rule of 2
's is another way to remember the criteria:
2
years of depressed mood (1 year in children and adolescents)2
of listed criteria2
months
During the 2
year period (1
year for children or 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.
Criteria for a major depressive disorder may be continuously present for 2
years.
There has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder.
The symptoms in Criterion A
are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
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).
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
4
symptoms that are absent from the symptom list for persistent depressive disorder (dysthymia), a very limited number of individuals will have depressive symptoms that have persisted longer than 2
years but will not meet criteria for persistent depressive disorder. Specify if:
Specify if (for most recent 2 years of persistent depressive disorder):
2
months without any significant symptoms of a major depressive episode following the end of such an episode.2
months, no significant signs or symptoms of the disturbance were present.2
of the following symptoms during the majority of days of a major depressive episode or persistent depressive disorder (dysthymia):2
symptoms3
symptoms4
or 5
symptoms4
or 5
symptoms and with motor agitation3
of the following manic/hypomanic symptoms are present nearly every day during the majority of days of a major depressive episode:1
of the following is present during the most severe period of the current episode:3
or more of the following:2
hours before usual awakening)This specifier can be applied when these features predominate during the majority of days of the current or most recent major depressive episode or persistent depressive disorder.
2
or more of the following:Delusions and/or hallucinations are present.
This specifier can apply to an episode of depression if catatonic features are present during most of the episode.
This specifier can be applied to the current or, if full criteria
are not currently met for a major depressive episode, most recent episode of major depression if onset of mood symptoms occurs during pregnancy or in the 4
weeks following delivery.
This specifier applies to recurrent major depressive disorder.
2
years, 2
major depressive episodes have occurred that demonstrate the temporal seasonal relationships defined above and no nonseasonal major depressive episodes have occurred during that same period.2
or more symptoms meeting criteria for a persistent depressive episode for 2
years or more, then PDD is diagnosed. The diagnosis depends on the 2
-year duration, which distinguishes it from episodes of depression that do not last 2
years.2
-year duration (i.e. - continuously over the course of 730 days [2 years]!) and is still present, then the specifier “with persistent major depressive episode” is used. 1
previous episode of major depression in the last 2
years of persistent depressive symptoms, then the specifier of “with intermittent major depressive episodes, without current episode” is used.