Disruptive Mood Dysregulation


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Identified as:

Children who are chronically irritable and experience frequent, severe outbursts that are unreasonable given the circumstances may be experiencing Disruptive Mood Dyregulation Disorder.

Characteristics (defined by DSM-V, May 2013)

  • Severe and recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation
  • Between outbursts, display an observable persistently irritable or angry mood most of the day and nearly every day
  • Symptoms present in 2 or more settings lasting at least 12 months
  • Not symptom free for 3 or more consecutive months
  • Onset of symptoms before age 10
  • May not be diagnosed before age 6 or after age 18
  • Symptoms do not occur as a result of another condition
  • Does not exhibit manic or hypomanic episodes

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Treatment Options (Child Mind Institute)

Because DMDD is a new disorder, there are no tested treatments. However, specific symptoms can be treated such as:

  • Psychosocial therapy
  • Anxiety or depression medication
  • Cognitive Behavioral Therapy
  • ADHD symptom medications

Continued Care

The following video describes the importance of continuing care in addition to therapy, medication, or other type of treatment. Parental positive reinforcement and consistent discipline is important to manage mood swings (tomschavo, 2012). Without reinforcement at home, treatments are less likely to be effective.
Disruptive behavior disorder - management, symptoms, diagnosis and treatment

Pros and Cons of DMDD Diagnoses

The pro to DMDD is that it separates the symptoms children experience from adults rather than as a sub-type of an adult disorder. According to the Child Mind Institute, Dr. Leibenluft's research identifies the differences in the explosive outbursts based on a connection with ADHD symptoms or manic episodes (Carlson, G., 2016). Adding the diagnostic criteria for children commonly diagnosed with Bipolar Disorder allows clinicians to more accurately and effectively treat the symptoms at earlier onset (Lliades, C., 2014). According to Ellen Leibenluft, research has shown that children who were commonly diagnosed with Pediatric Bipolar Disorder did not grow up to be diagnoses with Bipolar Disorder in adulthood (Lliades, C., 2014). However, research has not been established for the development of a new mood disorder and therefore DMDD has created controversy.

The criteria is closely related to Oppositional Defiant Disorder but children with ODD consistently display hostility and disobedience to authority figures specifically (DSM-5 Fact Sheet, 2013). Besides Oppositional Defiant Disorder, DMDD symptoms also overlap several other major mood disorders making it more difficult to diagnose. Because DMDD is a newly defined disorder, very little research is available to support the diagnoses or treatment. Additionally, if children are classified under the new DMDD diagnoses but may actually have a type of bipolar, treatment would be different and therefore possible harmful to the child if not treated properly (Juvenile Bipolar Research Foundation, nd).

Child Mind Institute

For more information or help, visit this website


Carlson, G. (2016). A New Diagnosis for Explosive Behavior. Child Mind Institute. Retrieved from http://childmind.org/article/pros-cons-disruptive-mood-dysregulation-disorder/

Child Mind Institute. (2016). Guide to disruptive mood dysregulation disorder. Retrieved from http://childmind.org/guide/guide-to-disruptive-mood-dysregulation-disorder/

DSM-V Fact Sheet. (May 2013). Disruptive Mood Dysregulation Disorder. Retrieved from http://www.dsm5.org/Documents/Disruptive%20Mood%20Dysregulation%20Disorder%20Fact%20Sheet.pdf

Grohol, J.M. (April 2, 2016). Angry Child image. PsychCentral. Retrieved from http://psychcentral.com/disorders/symptoms-of-disruptive-mood-dysregulation-disorder/

Juvenile Bipolar Research Foundation. (nd). Practical Clinical Concerns Regarding the DMDD Phenotype. Retrieved from http://www.jbrf.org/practical-clinical-concerns-regarding-the-tdd-phenotype/

Lliades, C. (October 25, 2014). Angry Girl image. PsychiatryAdvisor. Retrieved from http://www.psychiatryadvisor.com/childadolescent-psychiatry/disruptive-mood-dysregulation-disorder-current-concepts-and-controversies/article/379374/

Lliades, C. (October 25, 2014). Disruptive Mood Dysregulation Disorder Current Concepts and Controversies. PsychiatryAdvisor. Retrieved from http://www.psychiatryadvisor.com/childadolescent-psychiatry/disruptive-mood-dysregulation-disorder-current-concepts-and-controversies/article/379374/

tomschavo. (May 6, 2012). Disruptive behavior disorder - management, symptoms, diagnosis and treatment [video]. Retrieved from https://www.youtube.com/watch?v=5uo1XGzXq6U&nohtml5=False