[The dysthymia concept: current and historical aspects--an overview].

The article reviews the historical development of the understanding of dysthymia from C. F. Flemming (1844) to DSM-IV and to Akiskal's concepts. Recent results on epidemiology, comorbidity, neurobiology, familial patterns, clinical course, psychological characteristics, psycho- and pharmacotherapy of dysthymia are discussed. Although present concepts of dysthymia have led to results of high scientific and clinical relevance, the classification of chronic depression and their relation to both personality disorders and affective psychoses need further clarification. The development of dysthymia reflects the differences between Anglo-American operational psychiatric systems and the rich tradition of psychopathology in German-speaking psychiatry.