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Tests and diagnosis

By Mayo Clinic staff

When doctors suspect someone has dysthymia, they typically run a series of medical and psychological tests and exams. These can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:

  • Physical exam. This may include measuring your height and weight; checking your vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen.
  • Laboratory tests. These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
  • Psychological evaluation. A doctor or mental health provider talks to you about your thoughts, feelings and behavior patterns. He or she asks about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar issues in the past. You also discuss any thoughts you may have of suicide or self-harm. You may also be asked to fill out questionnaires about your mood and state of mind.

Checking for other conditions
Several other conditions have symptoms that may resemble the symptoms of dysthymia, including feeling sad or down, loss of interest in daily activities, and problems sleeping. Your doctor or mental health provider's evaluation will help determine if you have dysthymia or another condition that can affect your mood, such as:

  • Depression
  • Manic-depression (bipolar disorder)
  • Personality disorders
  • Seasonal affective disorder
  • Substance abuse disorder

Diagnostic criteria for dysthymia
To be diagnosed with dysthymia, you must meet the symptom criteria spelled out in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).

Main criterion
The main criterion to be diagnosed with dysthymia is:

  • Having a depressed mood most of the time for two or more years (in children, the duration must be at least one year, and their mood can be irritable rather than depressed).

Additional criteria
In addition to that, you must have at least two of these symptoms, and they must cause you distress or interfere with your ability to function in your daily life:

  • Poor appetite or overeating
  • Sleep problems
  • Fatigue or lack of energy
  • Low self-esteem
  • Hopelessness
  • Poor concentration
  • Trouble making decisions

Make sure you understand if you have been diagnosed with dysthymia or another condition so you can learn more about your specific situation and get appropriate treatment.

Treatments and drugs Preparing for your appointment
References
  1. Dysthymic disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com/content.aspx?aID=2375. Accessed May 12, 2010.
  2. Loosen PT, et al. Mood disorders. In: Ebert MH, et al. Current Diagnosis and Treatment: Psychiatry. 2nd ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=3285019. Accessed May 12, 2010.
  3. Depressive disorders. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec15/ch200/ch200b.html. Accessed May 12, 2010.
  4. Sansone RA, et al. Dysthymic disorder: Forlorn and overlooked? Psychiatry. 2009;6:46.
  5. Klein DN, et al. Ten-year prospective follow-up study of the naturalistic course of dysthymic disorder and double depression. American Journal of Psychiatry. 2006;163:872.
  6. Cuijpers P, et al. Psychotherapy for chronic major depression and dysthymia: A meta-analysis. Clinical Psychology Review. 2010;30:51.
  7. Imel ZE, et al. A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. Journal of Affective Disorders. 2008;110:197.
  8. Mood disorders. In: Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. Philadelphia, Pa.: Mosby; 2008. http://www.mdconsult.com/das/book/body/201023955-5/997725771/1657/636.html#4-u1.0-B978-0-323-04743-2..50071-8--cesec37_1902. Accessed May 13, 2010.
  9. Mead GE, et al. Exercise for depression (Review). Cochrane Database of Systematic Reviews. 2009:CD004366.
  10. Natural medicines in the clinical management of depression. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 13, 2010.
  11. Position of the American Dietetic Association and Dietitians of Canada: Dietary fatty acids. American Dietetic Association. http://www.eatright.org/WorkArea//DownloadAsset.aspx?id=8452. Accessed May 13, 2010.
  12. Smith CA. Acupuncture for depression (Review). Cochrane Database of Systematic Reviews. 2010:CD004046.
  13. Gray CM, et al. Complementary and alternative medicine use among health plan members. Effective Clinical Practice. 2002;5:17.
  14. Subodh BN. Psychosocial impact of dysthymia: A study among married patients. Journal of Affective Disorders. 2008;109:199.
DS01111 Aug. 26, 2010

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