Primary Early-Onset Dysthymia: Comparison With Primary Nonbipolar Nonchronic Major Depression on Demographic, Clinical, Familial, Personality, and Socioenvironmental Characteristics and Short-Term Outcome

In order to explore the characteristics and validity of DSM-III-R primary early-onset dysthymia, we compared outpatients with primary early-onset dysthymia (n = 32) and primary nonbipolar nonchronic major depression (n = 35). Fifty-nine percent of the dysthymics were currently in a major depressive episode, and 97% had a history of major depression. Compared with the episodic major depressives, the early-onset dysthymics exhibited significantly higher rates of melancholia, greater global impairment, and an earlier age of onset of major depression; were more likely to have recurrent major depressive episodes; and had higher rates of personality and substance use disorders. In addition, significantly higher proportions of early-onset dysthymics than nonchronic major depressives had family histories of affective and antisocial personality disorders. The dysthymics also exhibited significantly higher levels of depressive personality traits and self-criticism, lower levels of extraversion and social support, and higher levels of chronic strain and perceived stress than did the major depressives. Finally, the early-onset dysthymics exhibited significantly greater depression and poorer social and global functioning over the course of a 6-month follow-up.