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Persistent Depressive Disorder DSM 5TR

Diagnostic Criteria for Persistent Depressive Disorder

Persistent Depressive disorder has its code F4.1 in the DSM 5TR and diagnostic criteria that should be considered before viewing a person positive for the disease (First et al., 2022).

  1. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least two years.
  2. Presence, while depressed, of two (or more) of poor appetite or overeating., insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness.
  3. During the two years (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for over two months.
  4. Criteria for a major depressive disorder may be continuously present for two years.
  5. There has never been a manic episode or a hypomanic episode.
  6. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorders.
  7. The symptoms are not attributable to the physiological effects of a substance.
  8. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Developmental Considerations in Child Vs. Adolescent for Persistent Depressive Disorder.

Adolescents with PDD have continuous negative moods, low energy, sleep difficulties, and low self-esteem. PDD teens may retreat from family and friends due to social difficulties. Poor academic performance and attendance may also occur. Adolescents with PDD may struggle with identity, self-esteem, and healthy relationships. PDD teenagers may also misuse drugs, self-harm, and commit suicide.

PDD in children and adolescents is diagnosed and treated differently according to developmental factors. Age, developmental stage, and social and environmental context are critical for evaluating and treating PDD. Psychotherapy, medicine, and other supportive therapies may be used to treat the illness, along with social, developmental, and environmental aspects.

Warning Signs and Risk Factors for Persistent Depressive Disorder

Warning signs and risk factors for the illness may assist in identifying those at risk. Among them are genetic, physiological, medical illnesses, family history, temperamental, and environmental factors. Early depression increases PDD risk. Early depression may increase the incidence of PDD later in life (Cortés, 2022). Early-onset depression may impair emotional control, coping, and self-esteem, making people susceptible to PDD’s chronic poor mood and other symptoms. PDD is also linked to family depression. A family history of depression increases the likelihood of PDD. Genetics, family dynamics, parenting methods, and stresses or trauma may cause this. Prolonged stress may induce brain and body changes that exacerbate depression and other mental health conditions.

Abuse or trauma increases PDD risk. Physical, emotional, or sexual abuse may increase the risk of PDD. Trauma may permanently alter mood, behavior, and cognition, increasing the risk of depression. Persistent medical issues may raise PDD risk. Diabetes, cancer, and heart disease raise PDD risk. Chronic disease affects physical and emotional functioning, and maintaining a chronic condition is stressful. Lastly, social isolation increases PDD risk. PDD may be more likely in those with few friends. Social support gives emotional, practical, and a feeling of belonging, which protects against depression.


The potential effects of the disorder on development, the possibility of co-occurring disorders or comorbidities, the possibility of suicidal ideation or behavior, the impact of environmental and social factors, and medication management issues must all be carefully taken into account when working with children and adolescents who have been diagnosed with PDD. Mental health professionals may provide practical and thorough therapy for kids and teenagers with PDD by being aware of these worries and taking the proper measures to address them.

Cultural Considerations for Persistent Depressive Disorder

Some cultures stigmatize mental illness. Mental illness may be seen as a weakness or failure in certain cultures, discouraging treatment. Immigrants and refugees may experience significant challenges to mental health care (Cortés, 2022). Mental health practitioners must be aware of these cultural attitudes and give education and assistance to eliminate stigma and promote help-seeking. Mental health providers must be mindful of cultural variances in expressing melancholy and emotional discomfort to diagnose PDD effectively.


Cortés, A. S. (2022). Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-5-TR). American Psychiatric Association, 2022. https://doi. org/10.1176/apps. Books. 9780890425787. Psicooncología19(2), 339.

First, M. B., Yousif, L. H., Clarke, D. E., Wang, P. S., Gogtay, N., & Appelbaum, P. S. (2022). DSM‐5‐TR: an overview of what’s new and what’s changed. World Psychiatry21(2), 218.


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