eMedicine Specialties > Psychiatry > Adult

Dysthymic Disorder: Differential Diagnoses & Workup

Author: Sarah C Langenfeld, MD, Assistant Professor of Psychiatry, Department of Psychiatry, University of Massachusetts Medical School; Attending Psychiatrist, Community HealthLink
Coauthor(s): Rebecca S Lundquist, MD, Consulting Staff, Department of Psychiatry, UMass Memorial Medical Center; Brian R Szetela, MD, Assistant Professor, Department of Psychiatry, University of Massachusetts Medical School; Consulting Psychiatrist, Psychiatric Consultation - Liaison Service, University of Massachusetts Memorial Medical Center
Contributor Information and Disclosures

Updated: May 26, 2009

Differential Diagnoses

Alcoholism
Lyme Disease
Amphetamine-Related Psychiatric Disorders
Obsessive-Compulsive Disorder
Anemia
Panic Disorder
Anxiety Disorders
Personality Disorders
Apnea, Sleep
Posttraumatic Stress Disorder
Bipolar Affective Disorder
Schizophreniform Disorder
Chronic Fatigue Syndrome
Sedative, Hypnotic, Anxiolytic Use Disorders
Cocaine-Related Psychiatric Disorders
Social Phobia
Depression
Folic Acid Deficiency
Hypothyroidism

Other Problems to Be Considered

Substance abuse or dependence
Adjustment disorders
Grief

Workup

Laboratory Studies

  • Complete blood count with a sedimentation rate
  • Thyroid function tests
  • Homocysteine and methylmalonic acid levels may be better in detecting folate/vitamin B-12–responsive dysthymia than folate and vitamin B-12 levels themselves.

Imaging Studies

  • While fMRI offers promise in the differential diagnosis of dysthymia, it remains strictly a research tool.
  • Single-photon emission computed tomography (SPECT) is being offered commercially at some centers, but the existing database on depression seems too scant for this to be more than an experimental study for the depressive spectrum at this time.

More on Dysthymic Disorder

Overview: Dysthymic Disorder
Differential Diagnoses & Workup: Dysthymic Disorder
Treatment & Medication: Dysthymic Disorder
Follow-up: Dysthymic Disorder
Multimedia: Dysthymic Disorder
References
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Further Reading

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Keywords

dysthymic disorder, chronic depression, chronic depressive personality disorder, neurotic depression, minor depressive reaction, major depressive disorder, double depression, transient dysphorias, TCAs, SSRIs, dysthymia, depressive mood disorder, depression, chronic mood disorder

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Contributor Information and Disclosures

Author

Sarah C Langenfeld, MD, Assistant Professor of Psychiatry, Department of Psychiatry, University of Massachusetts Medical School; Attending Psychiatrist, Community HealthLink
Sarah C Langenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Rebecca S Lundquist, MD, Consulting Staff, Department of Psychiatry, UMass Memorial Medical Center
Rebecca S Lundquist, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: Pfizer Salary Employment

Brian R Szetela, MD, Assistant Professor, Department of Psychiatry, University of Massachusetts Medical School; Consulting Psychiatrist, Psychiatric Consultation - Liaison Service, University of Massachusetts Memorial Medical Center
Brian R Szetela, MD is a member of the following medical societies: American Psychiatric Association, American Society of Addiction Medicine, and Association for Convulsive Therapy
Disclosure: Nothing to disclose.

Medical Editor

Alan D Schmetzer, MD, Professor, Vice-Chair for Education, and Director of Residency Training in General and Addiction Psychiatry, Department of Psychiatry, Indiana University School of Medicine
Alan D Schmetzer, MD is a member of the following medical societies: American Academy of Addiction Psychiatry, American Academy of Clinical Psychiatrists, American Academy of Psychiatry and the Law, American College of Physician Executives, American Medical Association, American Neuropsychiatric Association, American Psychiatric Association, and Association for Convulsive Therapy
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

David Bienenfeld, MD, Vice-Chair, Program Director, Professor, Department of Psychiatry, Wright State University School of Medicine
David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Speaking and teaching; Northstar Grant/research funds Research; Novartis Grant/research funds research; Pfizer  Speaking and teaching; Sanofi-avetis Grant/research funds research; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
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