A longitudinal study of an untreated sample of predominantly late onset characterological dysthymia

The current study represents one of the first psychological investigations that attempts to describe the untreated course of late onset characterological dysthymia. Of 34 dysthymic subjects who were studied for 9 months, six women remitted (18%). Twenty-eight subjects (82%) remained unchanged. Among the nonremitters, we found stable patterns of functioning in the cognitive, coping, personality, interpersonal, and environmental spheres. The destructive nature of these refractory patterns appeared to predispose the individual to a depressionogenic lifestyle. These unchanging features were not found among the remitters. The small size of the remitting group makes our speculations tentative but we did find consistent changes over time across measures of functioning. While the symptom-affective features of the nonremitters remained at clinically significant levels throughout, the depressive symptom levels of the six remitters decreased to nonsignificant clinical levels during the last half of the study. It was noted that, based on these preliminary data, DSM-III-R may be "underdescriptive" in regard to relevant symptom features of characterological dysthymia.