An individual with a longstanding, low-grade depression (i.e., dysthymia) has been classically portrayed as habitually gloomy, introverted, brooding, overly conscientious, incapable of fun, and preoccupied with personal inadequacy and failure (3). The concept of dysthymia has gone through different stages of development and was officially included as an axis I condition in DSM-III, essentially replacing the DSM-II diagnosis of neurotic depression (4, 5). As an “independent” condition, dysthymic disorder was defined as a subsyndromal state (i.e., too few symptoms to meet criteria for a major depressive episode), with a protracted duration of at least 2 years in adults. It was characterized by an insidious onset, often in childhood or adolescence, and a persistent, intermittent, or fluctuating course (6). As seen in Table 1, the diagnosis of dysthymic disorder requires the presence of predominantly depressed mood for at least 2 years (criterion A; irritability and 1-year duration will satisfy criteria in children and adolescents) and at least two or more criterion B features (i.e., change in appetite, change in sleep, decreased energy, low self-esteem, difficulties concentrating or making decisions, or hopelessness). The presence of either a symptom-free period lasting longer than 2 months or the presence of a major depressive episode during the first 2 years of the onset of the condition (1 year for children and adolescents) rule out the diagnosis (criterion C and D). Although some people with bipolar disorder also experience longstanding mild depressions, the diagnosis of dysthymic disorder cannot be made when an individual has a history of mania, hypomania, mixed affective episodes, or cyclothymia (criterion E). A history of psychotic symptoms does not rule out a diagnosis of dysthymic disorder as long as mood symptoms are not exclusively present during psychotic episodes (criterion F). As is true of other DSM-IV affective disorders diagnoses, the symptoms should not be a direct consequence of substance abuse or a medical condition, and a significant functional impairment should be present as a consequence of the symptoms (criterion G and H) (7). In the current classification, several specifiers can be used to further describe the disorder, including early versus late onset (21 years being the cutoff point) and presence of atypical features (7). The distinction between early- and late-onset dysthymia is thought to have particularly important prognostic implications (7).