- F34
- Mood Disorders
Persistent Mood Disorders (F34)
DSM-5-TR: Persistent Depressive Disorder (Dysthymia) / Cyclothymic Disorder
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF30-F39
- Subcodes4 subcodes
- Australian PrevalenceFrequently encountered in Australian general practice but often underdiagnosed due to chronic, low-grade nature. Dysthymia prevalence estimated at 3-6%.
- Global PrevalenceDysthymia lifetime prevalence approximately 3-6%. Cyclothymia estimated at 0.4-1%.
- Duration RequirementAt least two years of persistent mood disturbance
Overview
Persistent mood disorders are chronic fluctuations of mood that are not sufficiently severe or prolonged enough to fulfil criteria for manic, hypomanic, or depressive episodes. They persist for years and sometimes for the greater part of a person's adult life, causing considerable distress and disability.
Diagnostic Criteria (ICD-10)
Core Features
- Persistent instability or depression of mood lasting at least two years
- Mood fluctuations not severe enough to meet criteria for manic, hypomanic, or depressive episodes
- Considerable subjective distress and functional impairment
- Intervening periods of normal mood rarely last longer than a few weeks
Duration At least two years of persistent mood disturbance
Severity Specifiers
- Cyclothymia (F34.0): alternating periods of mild depression and mild elation
- Dysthymia (F34.1): chronic low-grade depression of mood
Exclusion Criteria
- Episodes meeting criteria for mania, hypomania, or major depression (use F30-F33)
- Bipolar affective disorder (use F31)
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F34.0 | Cyclothymia | Persistent instability of mood involving numerous periods of mild depression and mild elation, none of which is severe or prolonged enough to meet criteria for bipolar disorder or recurrent depressive disorder. |
| F34.1 | Dysthymia | Chronic depression of mood lasting at least two years which is not sufficiently severe or prolonged to meet criteria for recurrent depressive disorder of mild, moderate, or severe degree. |
| F34.8 | Other persistent mood disorders | Other specified persistent mood disturbances. |
| F34.9 | Persistent mood disorder, unspecified | Persistent mood disorder where the specific type is unspecified. |
Classification Boundaries
Includes
- Cyclothymic personality
- Depressive personality
- Dysthymia
- Cyclothymia
Excludes1 (coded elsewhere)
- Bipolar affective disorder (F31)
- Recurrent depressive disorder (F33)
Australian Clinical Context
Persistent mood disorders are frequently encountered in Australian general practice but may be underdiagnosed due to their chronic, low-grade nature. Management typically involves psychological therapy (particularly CBT and interpersonal therapy) with or without antidepressant medication. Better Access MBS items apply for psychological treatment.
Medicare (MBS) Pathways
Better Access to Mental Health Care
The primary Medicare pathway for mental health treatment in Australia. Requires a GP Mental Health Treatment Plan (MHTP) referral. Available for any clinically diagnosed mental disorder.
10 individual + 10 group sessions per calendar year
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Clinical Psychologist | 80000–80025 | Psychological therapy (higher rebate) |
| Registered Psychologist | 80100–80123 | Focused psychological strategies |
| Occupational Therapist | 80125–80145 | Focused psychological strategies |
| Social Worker | 80150–80175 | Focused psychological strategies |
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
GP referral items: 2700, 2701, 2715, 2717
Eligibility: Any clinically diagnosed mental disorder as defined by WHO ICD-10 Chapter V. Requires a GP or psychiatrist referral.
Exclusions:
- Intellectual disability (use Complex Neurodevelopmental Disorder pathway or specialist referral)
- Dementia and organic mental disorders (use specialist referral pathway)
- Tobacco use disorder
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
Dysthymia (F34.1) maps to Persistent Depressive Disorder in DSM-5-TR. Diagnosis requires at least two years of persistent depressive symptoms. "Double depression" (dysthymia with superimposed major depressive episodes) should be coded with both F34.1 and the appropriate F32/F33 code.
Related Assessment Tools
Other validated instruments commonly used alongside the Persistent Mood Disorders (F34).
- PHQ-9
DepressionA 9-item screening tool for depression severity that maps onto the DSM-IV and DSM-5 criteriaCalculate → - DASS-21
StressA 21-item self-report measure of depression, anxiety, and stress with three 7-item subscalesCalculate → - CORE-10
Clinical OutcomesA 10-item measure of psychological distress for monitoring clinical outcomes in therapyCalculate →
Related Diagnostic Codes
ICD-10-AM diagnostic codes commonly associated with the Persistent Mood Disorders (F34).
Frequently Asked Questions
What is the difference between dysthymia and major depression?
Dysthymia (F34.1) involves chronic low-grade depressive symptoms lasting at least two years that do not meet full criteria for a major depressive episode. Major depression (F32/F33) involves more severe symptoms lasting at least two weeks. A person can have both simultaneously ("double depression").
References
- World Health Organization. ICD-10-AM.
- American Psychiatric Association. DSM-5-TR. 2022.
- RANZCP. Clinical Practice Guidelines for Mood Disorders.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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