Disruptive Mood Dysregulation Disorder: A New Diagnosis in the DSM-5

Abstract

This article explores a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.)-disruptive mood dysregulation disorder (DMDD). Frequent comorbidities of DMDD include oppositional defiant disorder and attention-deficit/hyperactivity disorder. The evolution of DMDD and how this diagnostic category may remedy an overdiagnosis of pediatric bipolar disorder are discussed.

Disruptive Mood Dysregulation Disorder

“…DMDD was initially created to differentiate and reduce the number of children diagnosed with the pediatric bipolar disorder (PBD). 3 Researchers found PBD and adult bipolar disorder (BD) varied in their presentation, with PBD characterized by chronic, nonepisodic irritability rather than classic manic episodes, which led to an increase in the diagnosis of PBD. 4 The concern of increasing prevalence of PBD between 1994 and 2004 was attributed to using a broad-based phenotype for diagnosis and its application with younger children.…”

“…[9][10][11][12][13] Although considered separate from PBD, many clinicians continue to question the validity of DMDD as a distinct condition because of its high comorbidity with other diagnoses such as oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD). 3 The data from studies indicate the rates of comorbidity with DMDD are wide ranging with percentages varying from 13% to 93% (mean ¼ 69%) for ODD and 21% to 81% (mean ¼ 52%) for ADHD. [14][15][16][17][18][19][20] In a recent study, 98.4% of children (n ¼ 665, aged 6e12, 52.6% male, 80.5% white) diagnosed with DMDD (n ¼ 61) met criteria for ODD or had a T score > 65 for ADHD, conduct disorder (CD), depression, or anxiety.…”

Disruptive Mood Dysregulation Disorder

“…Effective intervention strategies and approaches for treating those who have DMDD are still under investigation. Treatment protocols are limited due to the recent addition of the diagnosis to the DSM-5, as well as the findings that most children diagnosed with DMDD have a comorbid diagnosis such as ODD or ADHD (Johnson & McGuinness, 2014;Tourian et al, 2015). Treatments used to address bipolar disorder, oppositional defiant disorder, conduct disorder and ADHD are often applied in treating those who have DMDD (Manis, Norris, Paylo, & Kress, 2015).…”

Structural Equation Modeling (SEM): Gaming Disorder Mediating Untreated Attention Deficit Hyperactivity Disorder to Disruptive Mood Dysregulation

“…Internet gaming disorder (IGD) is a new mental disorder and quite prevalent among recent child and adolescent, especially in lockdown period of COVID- 19 19. Clinically, child and adolescent psychiatrist increasingly recognize many youth experience mood dysregulations in combination with irritability, frequent temper outburst after their parents stopping their overly internet gaming behavior.…”