[Dysthymia: a chronic illness and its treatment].

Dysthymia is a chronic disease with a high psychosocial burden. Age of onset frequently is in young adulthood. It is clinically characterized by very mild but continuous chronic depressive symptoms. The quality of symptoms seems to be similar to episodic depressive disorders, but the severity criteria for major depression are not fulfilled. After more than 2 years of dysthymia a depressive episode may occur (double depression). Neurobiological and genetic findings indicate a relation of dysthymia to affective disorders. Antidepressants are proven to be effective without a difference between various types of drugs. Psychotherapy is also proven to be effective (e.g. behaviour therapy) and should be prescribed in combination or alone, if a patient refused to take drugs. Because of the preferable side-effect profile of newer antidepressant compounds, they should be prescribed as first choice. A prophylactic treatment for 2 years is recommended. The dose of antidepressants should be in the therapeutic range for treatment of major depression.