Dysthymic Disorder Causes More Disability Than Major Depression

Article excerpt

BOCA RATON, FLA. -- Dysthymic disorder, also known as chronic low-grade depression, confers a high degree of impairment and represents a significant public health burden, according to a secondary analysis of a large epidemiologic study.

"The point is, dysthymia is a very dysfunctional illness, even relative to acute major depression," Dr. Jonathan W. Stewart said the meeting.

The investigators found greater impairments in some psychosocial-functioning indicators for the previous month and the previous year among people with dysthymic disorder, compared either with others who had acute major depressive disorder or with the general population. The dysthymic patients had greater use of supplemental Social Security disability income and higher receipt of Medicaid insurance, and were less likely to be working full time compared with the other groups, according to results that were published online (J. Affect. Disord. 2010 May 1 [Epub ahead of print]).

"This is not the way a lot of people view dysthymia. Dysthymia is what ruins peoples' lives," said Dr. Stewart of Columbia University and the New York State Psychiatric Institute, both in New York City.

In the previous year, Social Security disability was reported by 14% of the dysthymic group, 5% of the major depression group, and 3% of the general population group. Receipt of Medicaid insurance was reported by 20% of the dysthymic group, 13% of the major depression group, and 6% of the general population participants.

These results come from their secondary analysis of NESARC (National Epidemiologic Survey of Alcoholism and Related Conditions). NESARC features a nationally representative sample of 43,093 noninstitutionalized U.S. adults. Dr. Stewart and his associates identified 328 respondents with dysthymic disorder (without current major depression); 712 with acute major depressive disorder (symptoms for 24 months or fewer); and 42,052 other participants who accounted for the general population group.

Full-time employment was reported by 36% of the dysthymic patients, 44% of the major depression patients, and 52% of the general population.

The investigators also assessed previous month functioning using the 12-item Short Form Health Survey scores. For example, participants were asked the following questions:

* Have you accomplished less because of emotional problems? In all, 13% of the dysthymic group, 8% of the major depression group, and 3% of the general population group said "all of the time. …