Persistent depressive disorder, or PDD, represents the DSM-5 consolidation of previously defined DSM-IV-TR diagnoses (persistent depressive disorder and chronic major depressive disorder).
PDD may be diagnosed in pediatric patients, either children or adolescents, when a pervasive depressed or irritable mood is present for at least 1 year. Two additional symptoms of depression must also be present for most of the day at least half of the time during that year to make the diagnosis. Depressive symptoms typical in persisten depressive disorder include the following
(see Prognosis, Presentation, and Workup):
Diminished or increased appetite
Insomnia or hypersomnia
Low energy or fatigue
Difficulties with concentration or decision making
Feelings of hopelessness
To qualify for a diagnosis of PDD, a child may have never had a manic or hypomanic episode. A child may not have had symptom-free intervals lasting longer than two months.
Education about the long-term risks of dysthymic disorder and the role of behavioral and cognitive-behavioral interventions, as well as instruction in social and interpersonal skills, can be helpful adjuncts to treatment. (See Treatment.)