DMDD

Disruptive Mood Dysregulation Disorder

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What is Disruptive Mood Dysregulation Disorder?

Disruptive Mood Dysregulation Disorder is an addition to the DSM-5. This disorder occurs when a youth has chronic irritability and outbursts of anger which result in recurrent intense temper tantrums that are out of proportion in or duration to the situation (Axelson D, Findling R.L, & Fristad M, 2012). An example of DMDD would be a child that is having a 20-minute outburst because someone ate the last cookie. This is a relatively new disorder that was created in order to prevent children from being misdiagnosed as being bipolar disorder (Axelson, 2013).

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Age and Criteria for Diagnosis

This is a disorder affects children and adolescents. A child cannot be diagnosed until the age of six or after the age of 18; however, most symptoms have presented themselves by 10 years old (Zepf & Holtmann, n.d.).

The criteria in order for a child to be diagnosed with DMDD include the following:

  • Severe temper tantrums that are over the top and not consistent with the child’s stage of development.

  • Tantrums must occur an average of three times a week.

  • Symptoms have presented themselves for at least 12 months and the child has not been symptom free for over three consecutive months.

  • Must be over the age of 6 and the behavior must have occurred in more than one instance

  • Does not meet criteria for another mental disorder but it can coexist with oppositional defiant disorder, ADHD, conduct disorder or substance use disorder (Zepf & Holtmann, n.d.).

It is possible for a child to be diagnosed with ADHD and oppositional defiant disorder, ODD; at least 26% of children who were diagnosed with ADHD and 25% of children who were diagnosed with ODD met the criteria for DMDD (Tourainan, LeBoeuf, & Berton, 2015)

Pros and Cons of Diagnosis

One pro of being diagnosed with DMDD is the reason why the diagnoses was created in the first place which was to prevent children from being misdiagnosed with bipolar disorder. Another pro is that there is less stigma attached to being diagnosed with DMDD which is easier to treat and overcome than a bipolar diagnosis. The treatment for bipolar disorder is prescribed medication which will have to be taken for life in order to stabilize the mood swings in addition to therapy to help the person understand and deal with their diagnosis (Maisto, 2013).

A con of a child that has been diagnosed with disruptive mood dysregulation disorder is they may actually suffer from bipolar disorder and according to the criteria a child cannot diagnosed with both DMDD and bipolar disorder. Children who may have bipolar disorder would not present the same symptoms of adults who suffer from this disorder. For example, children can have the mood swings and depression that are symptoms of bipolar disorder but not the mania which would exclude them from being diagnosed with bipolar disorder; however, mania symptoms include an increased sex drive and having grandiose ideas and plans which between the ages of 6-10, when a child is usually diagnosed with DMDD, is not part of their development at this age (Maisto, 2013).

Treatment Options

While there is not a treatment guideline for DMDD, the individual symptoms are usually treated; for example, aggression is treated using the medications methylphenidate or risperidone and behavior is treated using family and behavior therapy (Tourainan, LeBoeuf, & Berton, 2015)

References

Axelson D, M., Findling R.L, M. M., & Fristad M, P. A. (2012). Examining the Proposed Disruptive Mood Dysregulation Disorder Diagnosis in Children in the Longitudinal Assessment of Manic Symptoms Study. J Clinical Psychiatry, 1342-1350. doi:10.4088/JCP.12m07674

Axelson, D. M. (2013, February). Taking Disruptive Mood Dystegulation Disorder Out for a Test Drive. The Journal of American Psychiatry, 136-139. Retrieved from http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2012.12111434

Maisto, C. G. (2013). Understanding Psychology (10th ed.). Upper Saddle River, NJ: Pearson.

Tourainan, L., LeBoeuf, A., & Berton, J. (2015, March 4). Treatment Options for the Cardinal Symptoms of Disruptive Mood Dysregulation Disorder. Journal of the Canadian Academy of Child and Adolescent Psychiarty, 41-54. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357333/

Zepf, F. D., & Holtmann, M. (n.d.). Disruptive Mood Dysregulation Disorder. Retrieved from http://iacapap.org/wp-content/uploads/E.3-MOOD-DYSREGULATION-072012.pdf