Disruptive mood dysregulation disorder: A better understanding | DMDD
Disruptive mood dysregulation disorder (DMDD)—a childhood condition of extreme irritability, anger, and frequent, intense temper outbursts—has been a source ...SkiptocontentDisruptivemooddysregulationdisorder:AbetterunderstandingDisruptivemooddysregulationdisorder:AbetterunderstandingDownloadthepdfHERE.RecognizingkeydifferencesinDMDDcanhelpdistinguishitfromsimilarpediatricdisorders.Disruptivemooddysregulationdisorder(DMDD)—achildhoodconditionofextremeirritability,anger,andfrequent,intensetemperoutbursts—hasbeenasourceofcontroversyamongcliniciansinthefieldofpediatricmentalhealth.BeforeDSM-5waspublished,thevalidityofDMDDhadbeenquestionedbecauseDMDDhadfailedafieldtrial;agreementbetweencliniciansonthediagnosisofDMDDwaspoor.1Axelson2andBirmaheretal3examineditsvalidityintheirCOBY(CourseandOutcomeofBipolarYouth)sample.Theyconcludedthatonly19%metthecriteriaforDMDDin3timesoffollow-up.Furthermore,mostDMDDcriteriaoverlapwiththoseofothercommonpediatricpsychiatricdisorders,includingoppositionaldefiantdisorder(ODD),attention-deficit/hyperactivitydisorder(ADHD),andpediatricbipolardisorder(BD).BecausediagnosisofpediatricBDincreaseddrasticallyfrom2.9%to15.1%between1990and2000,4itwasbelievedthatintroducingDMDDasadiagnosismightlessentheoverdiagnosisofpediatricBDbyidentifyingchildrenwithchronicirritabilityandtempertantrumswhopreviouslywouldhavebeendiagnosedwithBD.Itisimportanttorecognizethatinpediatricpatients,mooddisorderspresentdifferentlythantheydoinadults.5Inchildren/adolescents,mooddisordersarelesslikelytopresentasdistinctepisodes(narrowband),butmorelikelytopresentaschronic,broadsymptoms.Also,irritabilityisacommonpresentationinmanypediatricpsychiatricdisorders,suchasODD,BD(irritabilitywithoutelation),6anddepression.Thus,formanyclinicians,determiningthecorrectmooddisorderdiagnosisinpediatricpatientscanbechallenging.ThisarticledescribesthediagnosisofDMDD,andhowitspresentationissimilarto—anddifferentfrom—thoseofothercommonpediatricpsychiatricdisorders.TheoriginofDMDDManyresearchersha