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Chronic Depressive Disorders

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Handbook of Outpatient Treatment of Adults

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Abstract

Chronic depression represents a relatively new focus for psychiatry, and there have been few systematic studies on the subject. The term dysthymic disorder was introduced into the psychiatric nomenclature in the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III; APA, 1980) to categorize chronic depressions that are of a long duration but less severe than major depressive episodes. It was used to replace the concept of neurotic depression in the second edition of the manual (DSM-II; APA, 1968). This revision arose as a result of studies (Akiskal, Bitar, Puzantian, Rosenthal, & Walker, 1978; Kendell, 1976; Kiloh, Andrews, Nielson, & Bianchi, 1972; Klein, 1974; Klerman, Endicott, Spitzer, & Hirschfeld, 1979; Paykel, 1971) showing substantial heterogeneity in neurotic depressions and as the result of a decision to create a diagnostic category based purely on phenomenology (Spitzer, Williams, & Skodol, 1980). An important aspect of this change is that, in the DSM-III, dysthymic disorder is included in Axis I as an affective disorder, and there is no category for chronic depression in the personality disorder section of the DSM-III. This basic structure has been maintained in the revised DSM-III (DSM-III-R; APA, 1986), although there have been several important modifications from the DSM-III criteria.

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Authors and Affiliations

  1. Massachusetts General Hospital, Boston, Massachusetts, 02114, USA

    Martin B. Keller & Frances M. Sessa

  2. University of California at Berkeley, Berkeley, California, 94720, USA

    Lauren P. Jones

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Editors and Affiliations

  1. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 15213, Pittsburgh, Pennsylvania, USA

    Michael E. Thase M.D.

  2. West Virginia University, Morgantown, West Virginia, USA

    Barry A. Edelstein Ph.D.

  3. Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA

    Michel Hersen Ph.D.

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Keller, M.B., Sessa, F.M., Jones, L.P. (1990). Chronic Depressive Disorders. In: Thase, M.E., Edelstein, B.A., Hersen, M. (eds) Handbook of Outpatient Treatment of Adults. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0894-0_7

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