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Minor Depression: Midway between Major Depression and Euthymia

Kurt Kroenke, MD
[+] Article, Author, and Disclosure Information

From Regenstrief Institute, Inc., Indianapolis, IN 46202.

Potential Financial Conflicts of Interest: Honoraria and grants received: Eli Lilly Inc., Pfizer Inc., Wyeth.

Requests for Single Reprints: Kurt Kroenke, MD, Regenstrief Institute, Inc., RG-6, 1050 Wishard Boulevard, Indianapolis, IN 46202; e-mail, kkroenke@regenstrief.org.

Ann Intern Med. 2006;144(7):528-530. doi:10.7326/0003-4819-144-7-200604040-00013
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When it comes to mood disorders, major depression has dominated the headlines. Diagnosis of major depression requires that the patient have at least 5 of 9 criterion symptoms (1 of which must be depressed mood or anhedonia) nearly every day for 2 or more weeks. Attracting somewhat less attention, dysthymia is a chronic disorder that manifests as depressive symptoms that persist more days than not for several years. Diagnosis of dysthymia does not require at least 5 symptoms, unlike major depression. Minor depression has been the Cinderella of the 3 conditions: The diagnosis requires neither meeting the symptom threshold of major depression nor the chronicity threshold of dysthymia. Mood disorder research has corresponded to this rank ordering. Therefore, clinicians have a rather robust evidence-based approach to the management of major depression, a more modest understanding of what to do for the patient with dysthymia, and even fewer data to guide them in caring for the patient with minor depression.

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