Key points

This specifier should be used if the onset of the dysthymic symptoms occurs before age 21 years.
This specifier should be used if the pattern of symptoms during the most recent 2 years of the disorder meets the criteria for With Atypical Features.
This specifier should be used if the onset of the dysthymic symptoms occurs at age 21 or older.
Such individuals are more likely to develop subsequent Major Depressive Episodes.

Age at onset and the characteristic pattern of symptoms in Dysthymic Disorder may be indicated by using the following specifiers:

Early Onset. This specifier should be used if the onset of the dysthymic symptoms occurs before age 21 years. Such individuals are more likely to develop subsequent Major Depressive Episodes.

Late Onset. This specifier should be used if the onset of the dysthymic symptoms occurs at age 21 or older.

With Atypical Features. This specifier should be used if the pattern of symptoms during the most recent 2 years of the disorder meets the criteria for With Atypical Features.

Revised and edited by

David Mazoor, M.D.

Medically reviewedLast reviewed October 8, 2025

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