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Pediatric Persistent Depressive Disorder (Dysthymia)


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

Poor self-esteem

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.

Patient education

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.)

For patient education information, see the Depression Center, as well as Depression.

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