A 38-year-old woman presents with persistent low mood for 2 years with periods of 2-month improvement but never achieving full euthymia. She has never had a major depressive episode or hypomanic episode. What is the DSM-5 diagnosis and minimum symptom duration required for this diagnosis?
- A Major depressive disorder, recurrent; no specific minimum additional duration
- B Cyclothymic disorder; at least 2 years
- C Persistent depressive disorder (dysthymia); at least 2 years ✓
- D Bipolar II disorder; at least 1 year
Correct answer: C. Persistent depressive disorder (dysthymia); at least 2 years
Explanation
Persistent depressive disorder (PDD/dysthymia) in DSM-5 requires depressed mood for most of the day, more days than not, for at least 2 years in adults (1 year in children/adolescents), with the depressive symptoms present without euthymia exceeding 2 consecutive months. The patient has never had a major depressive episode (which would qualify as MDD) nor a hypomanic/manic episode. Cyclothymic disorder requires alternating hypomanic and depressive symptoms not meeting full criteria, for ≥2 years.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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