E-ISSN 1309-4866
Research Article
Persistent Depression as a Novel Diagnostic Category: Results from the Menderes Depression Study
1 Ermenek Devlet Hastanesi, Psikiyatri Kliniği, Karaman, Türkiye  
2 İzmir Tepecik Eğitim ve Araştırma Hastanesi, Psikiyatri Kliniği, İzmir, Türkiye  
3 Adnan Menderes Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, Aydın, Türkiye  
Arch Neuropsychiatry 2015; 52: 359-366
DOI: 10.5152/npa.2015.7589
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Key Words: Depression, dysthymic disorder, double depression, prevalence
Abstract

Introduction: Persistent depressive disorder (PDD) introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 as a novel diagnostic category represents a consolidation of two separate DSM-IV categories, chronic major depressive disorder (MDD) and dysthymic disorder. The present study aims to investigate the frequency and clinical as well as socio-demographic correlates of PDD in comparison with those of episodic MDD among patients seeking treatment for depressive symptoms.

 

Methods: Participants were 140 depressive out-and in-patients under treatment at the psychiatry clinic of the Adnan Menderes University Research Hospital. Each patient was assessed by means of a structured clinical interview (SCID-I) and relevant psychometric instruments including the Hamilton Depression Inventory and Eskin Suicidal Behavior Inventory.

 

Results: Among the depressive patients, 61% fulfilled the criteria for PDD and 39% for episodic MDD. As compared with patients with episodic MDD, the PDD patients were older (d=.54), lower in educational attainment (d=.55), more likely to have comorbid generalized anxiety disorder (OR=3.7), and more prone to report symptoms of anxiety, hopelessness, pessimism, and somatic complaints. Nevertheless, the PDD patients displayed heterogeneous characteristics with respect to clinical severity and suicidal behavior.

 

Conclusion: Our findings suggest that majority of depressive patients, including those fulfilling the criteria for MDD, have been suffering from a persistent ailment rather than an episodic disorder. Clinicians with a cross-sectional perspective are more likely to diagnose MDD, whereas those with a longitudinal perspective are more likely to identify PDD in the majority of depressive patients. The incorporation of both of these perspectives into DSM-5 in a complementary manner will possibly enhance our insight into depressive disorders and improve our treatment results. 

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