Depression lasting more than 2 years is termed either chronic depression, dysthymia, or ?double depression' (dysthymia leading to depression without an intermediate remission).
Dysthymia is characterised by:
Presence of depressed mood throughout the day (more days than not) for at least 2 years (or 1 year in children and adolescents), in addition to at least 2 of the following associated symptoms: (1) poor appetite or overeating, (2) insomnia or hypersomnia, (3) low energy or fatigue, (4) low self-esteem, (5) poor concentration or difficulty making decisions, and (6) feelings of hopelessness.Chronic major depression is diagnosed when 5 or more depressive symptoms are present for at least 2 years.
Chronic depression and dysthymia are common disorders affecting approximately 3% of the adult population.[12]
However, this type of illness continues to be under-recognized and under-treated. A recent consensus statement by the National Depressive and Manic-Depressive Association observed from several studies that up to two-thirds of patients who have been ill for 20 years or more have never undergone a trial of any antidepressant.
Some figures suggest that as few as 5% of patients have received an adequate trial of treatment.[13]
Women seem to be at least twice as likely as men to develop a chronic depressive illness, and early onset (before age 21) is common. This is a cross-cultural, worldwide finding.
Chronic depression tends to occur in tandem with other conditions, including chronic pain.
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