Dysthymia in clinical practice. The WPA Dysthymia Working Group.

BACKGROUND

Dysthymia has been reconceptualised in recent years from a personality disorder to a chronic affective disorder. It is incorporated into both the DSM and ICD diagnostic systems.

METHOD

The members of the WPA Dysthymia Working Group combined the results of their manual literature searches with a search using Medline.

RESULTS

Available data are summarised under the headings of classification, epidemiology, validity, comorbidity, course and outcome, pharmacotherapy and psychotherapy. The coexistence of major depressive disorder, constituting 'double depression' is of particular importance.

CONCLUSIONS

Improved knowledge of this disorder has led to a more positive approach to treatment, in which antidepressants can usefully be complemented by psychosocial measures. A high proportion of cases remain unrecognised in most populations, leading to prolonged morbidity and distress, much of which is now treatable.