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Disruptive Mood Dysregulation Disorder

Rashmi Nemade, Ph.D., edited by Kathryn Patricelli, MA

In recent years, concerns were raised about the diagnosis of bipolar disorder in children. It was decided that bipolar disorder was being over diagnosed and over treated in children and that these children may benefit from other kinds of treatment. Because of this, a new diagnosis was created in Depressive Disorders called Disruptive Mood Dysregulation Disorder. This condition is used to describe children (up to 12 years of age) who experience ongoing irritability and have frequent episodes of out-of-control behavior. This behavior is violent and aggressive. These children usually develop major depressive disorder or anxiety disorders, rather than bipolar disorders, as they get older.

In this condition, children have severe ongoing temper outbursts 3 or more times per week. These can be verbal or physical and can be towards people or property. Although these outbursts often happen because of frustration, these behaviors are way out of proportion to what would be typically expected in the situation and for the age of the child.

When not having an outburst, the child's mood is irritable or angry most of the day, every day. This is noticed by others such as teachers, parents, peers. The child often has difficulty participating in activities, doing well in school, and making or keeping friendships. This condition causes severe problems in the lives of the child and their families. Dangerous or risky behavior, suicidal thoughts and attempts, severe aggression and psychiatric hospitalization are common.

This condition is different from pediatric bipolar disorders, oppositional defiant disorder, and attention-deficit/hyperactivity disorder, MDD, anxiety disorders, autism spectrum disorders, and intermittent explosive disorder. However, it is rare for this condition to occur by itself and the child typically has other mental health issues that the clinician must discover and treat.