title: Dysthymia and the Spectrum of Chronic Depressions
author: Hagop S. Akiskal
description: <DIV>"Hagop S. Akiskal introduced the concept of chronic depression into modern psychiatry and convinced us all of its clinical and public health importance. His rich descriptions combine poignant clinical phenomenology with modern scientific data. This volume is a compendium of the latest thinking on the concept, the diagnosis, and the treatment of chronic depression. It is a 'must read' for every clinician and every clinical researcher." --Robert M. A. Hirschfeld, MD, Titus H. Harris Distinguished Professor and Chair, Department of Psychiatry and Behavioral Sciences, The University of Texas <br><br>"Revolutionary changes have emerged recently in the way we conceptualize and treat dysthymia and related chronic depressive disorders. Hagop S. Akiskal, a pioneer in this area, is joined by a talented international cast to document the clinical impact of these scientific advances. The resulting book provides mental health clinicians with an elegant, avant-garde, yet practical compendium on this prevalent spectrum of chronic depressive suffering." --Lewis L. Judd, MD, Mary Gilman Marston Professor and Chair, Department of Psychiatry, University of California, San Diego; Former Director, National Institute of Mental Health (NIMH) <br></div>
zlib_text: Defining the Problem
  Depression is more than just “the blues.” It is a treatable
  illness that can range from mild to severe. Dysthymia, the
  mild form, involves long-term, chronic symptoms that do not
  seriously debilitate but do prevent a sense of general well-
  being. Many people with dysthymia also experience more
  severe depression or a major depressive episode at some
  time in their lives. The American Psychiatric Association
  Diagnostic and Statistical Manual of Mental Disorders,
  Fourth Edition (DSM-IV) defines a major depressive episode
  as either a depressed mood or lack of interest or pleasure in
  most activities, for most of the day nearly every day, that
  lasts for at least two consecutive weeks, is not accounted for by other reasons
  (e.g., bereavement, physical illness), and seriously impacts day-to-day functioning.
  Children and adolescents with depression may appear irritable rather than sad. Additional
  symptoms for this group may include the following:
  � Missed school or worsened 