Prevalence of dysthymic disorder in primary care.
BACKGROUND
Dysthymic disorder is characterised as a chronic state of depressed mood which is not otherwise attributable to physical, psychological or social events. While it can occur alone, there is increasing evidence that the majority of individuals who meet criteria for dysthymic disorder also experience more severe episodic mood disorders throughout their lifetime, and there is also an aggregation of mood disorders within their family members. Patients with dysthymic disorder are most often seen in primary care. Some researchers suggest that the majority of these individuals are never diagnosed or are not diagnosed until a more severe episodic mood disorder develops. The objective of this study was to determine the 12-month prevalence of Axis I psychiatric disorders, and in particular dysthymic disorder, in a primary care Health Service Organization in Ontario, Canada.


METHODS
Eligible and consenting adults registered with a primary care Health Service Organization were screened using the modified form of the University of Michigan Composite International Diagnostic Interview.


RESULTS
Of the 6280 eligible subjects, 4327 (69%) consented to screening. Two hundred and twenty-two (5.1%) subjects screened positive for dysthymic disorder. In addition, 90% of those who screened positive for dysthymic disorder also screened positive for other Axis I disorders including major depressive disorder, panic, simple phobia, and generalized anxiety disorder.


CONCLUSIONS
There is much potential for the primary care physician to play a pivotal role in the recognition and treatment of dysthymic disorder and associated Axis I disorders. A focus on the family as a unit for care may be especially important given the reported aggregation of dysthymic disorder within families.
Steiner
M
M
System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Ontario, Canada.
Bell
B
B
Browne
G
G
Roberts
J
J
Gafni
A
A
Byrne
C
C
Dunn
E
E
Chalkin
L
L
Kraemer
J
J
Mills
M
M
Wallik
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*