Chronic Depressive Disorders

  • Martin B. Keller
  • Frances M. Sessa
  • Lauren P. Jones


Chronic depression represents a relatively new focus for psychiatry, and there have been few systematic studies on the subject. The term dysthymic disorder was introduced into the psychiatric nomenclature in the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III; APA, 1980) to categorize chronic depressions that are of a long duration but less severe than major depressive episodes. It was used to replace the concept of neurotic depression in the second edition of the manual (DSM-II; APA, 1968). This revision arose as a result of studies (Akiskal, Bitar, Puzantian, Rosenthal, & Walker, 1978; Kendell, 1976; Kiloh, Andrews, Nielson, & Bianchi, 1972; Klein, 1974; Klerman, Endicott, Spitzer, & Hirschfeld, 1979; Paykel, 1971) showing substantial heterogeneity in neurotic depressions and as the result of a decision to create a diagnostic category based purely on phenomenology (Spitzer, Williams, & Skodol, 1980). An important aspect of this change is that, in the DSM-III, dysthymic disorder is included in Axis I as an affective disorder, and there is no category for chronic depression in the personality disorder section of the DSM-III. This basic structure has been maintained in the revised DSM-III (DSM-III-R; APA, 1986), although there have been several important modifications from the DSM-III criteria.


Major Depression Affective Disorder Personality Disorder Major Depressive Disorder Major Depressive Episode 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Martin B. Keller
    • 1
  • Frances M. Sessa
    • 1
  • Lauren P. Jones
    • 2
  1. 1.Massachusetts General HospitalBostonUSA
  2. 2.University of California at BerkeleyBerkeleyUSA

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