Children Bipolar Disorder

Disruptive Mood Dysregulation Disorder

What is Disruptive Mood Dysregultion Disorder(DMDD)

DMDD belongs to the category of mood disorders and has been created to improve recognition of a condition characterized by both mood and behavioral symptoms and to avoid a diagnosis of bipolar disorder in children and adolescents with severe chronic irritability and temper tantrums(Purper-Ouakil, 2014).

Age Ranges for Diagnosis of DMDD

A diagnosis should not be made for the first time before a child is 6 years old or after 18 years old. A child's history or observation has shown that age of onset is before 10 years of age (Rao, 2014).
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Criteria for Diagnosis of DMDD

Criteria for DMDD include the following: (1) severe, recurrent (≥3 times/week) temper outbursts (verbally and/or behaviorally) that are grossly out of proportion in intensity or duration to the situation, and inconsistent with the developmental level; (2) the mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and observable by others; (3) the symptoms must be present for 12 or more months, with no more than 3 consecutive months of symptom-free period; (4) the symptoms/behaviors must be present at least in two of three settings (i.e., at home, at school, with peers), and to a severe degree at least in one setting; (5) the diagnosis should not be made for the first time before age 6 years or after 18 years; and (6) by history or observation, the age at onset is before 10 years. Certain exclusion criteria are included: (1) the behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder and (2) DMDD cannot co-exist with bipolar disorder, intermittent explosive disorder or ODD (Rao, 2014).
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Pros of Assessing DMDD

--The treatment for DMDD will be individualized to the needs of the particular child and his or her family. It may include individual therapy, as well as work with the child's family and/or school (AACP, 2013).

--Addresses concerns about the potential for the over-diagnosis and treatment of Bipolar Disorder in children (Rao, 2014).

Cons of Assessing DMDD

--Many children are irritable, upset or moody from time to time. Occasional temper tantrums are also a normal part of growing up.

--Some of the symptoms associated with DMDD are also present in other child psychiatric disorders, such as depression, bipolar disorder and oppositional defiant disorder (AACP, 2013).

--No published data using the proposed diagnostic criteria for youth (Rao, 2014).


AACAP. (2013). Disruptive Mood Dysregulation Disorder (DMDD).

Purper-Ouakil, D. (2014). Disruptive Mood Dysregulation Disorder. ScienceDirect, 172(8), 663-666.

Rao, U. (2014). DSM-5: Disruptive Mood Dysregulation Disorder. Asian Journal of Psychiatry, 11, 119-123