Recognition and management of dysthymic disorder.

Dysthymic disorder, a chronic disturbance of mood, manifests as depressed mood for most of the day, more days than not, for at least two years. In children, dysthymia may present as irritable mood, and a duration of symptoms of only one year is required to make the diagnosis. By definition, there is no history of a major depressive disorder. Associated symptoms include poor appetite or overeating, insomnia or hypersomnia, poor concentration or difficulty making decisions, low energy, low self-esteem and feelings of hopelessness. Because of the chronic nature of this disorder, treatment requires an understanding approach and continuity of care.