Disruptive Mood Dysregulation Disorder (DMDD)

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) categorizes disruptive mood dysregulation disorder (DMDD) as a childhood depressive condition that causes extreme irritability, anger, and frequent, intense temper outbursts. Psychiatric experts added disruptive mood dysregulation disorder to the DSM-5 in 2013. This addition now provides an alternate diagnosis for adolescents who had previously received a misdiagnosis of other conditions such as bipolar disorder.

Symptoms of disruptive mood dysregulation disorder cause significant impairment requiring clinical assessment and intervention. Disruptive mood dysregulation disorder should not be confused with minor, occasional “temper tantrums,” as children with this condition react disproportionately to situations with severe and recurrent outbursts.

Signs and Symptoms of DMDD

To be clinically diagnosed, symptoms must be recurrent and present for at least 12 months. Signs must not be absent for periods of 3 months or more out of those 12 months to meet the diagnostic criteria of DMDD.

Symptoms include:

Persistent irritable or angry mood (multiple days per week) that is present in at least two settings, such as home and school
Severe temper outbursts (verbal or behavioral) at an average of three or more times per week that are out of keeping with the situation and the child’s developmental level
Trouble functioning due to irritability in multiple aspects of life, such as school, in social settings, or at home

Mental health professionals can only make an accurate diagnosis of disruptive mood dysregulation disorder in children over age 6. Symptoms of disruptive mood dysregulation disorder are often present by the age of 10.

Does DMDD Persist Beyond Childhood?

While disruptive mood regulation disorder is an adolescent condition, it may have a lasting impact on adulthood. Research shows that children with disruptive mood dysregulation disorder have a higher chance of meeting the criteria for psychiatric disorders such as depression and anxiety disorders in adulthood. Socio-economic issues in adulthood are also common for those who suffered from disruptive mood dysregulation disorder as adolescents. These include having lower education levels, difficulty with employment, and subsequent poor financial health.

Evaluation and Treatment of DMDD

Disruptive mood dysregulation disorder is a serious condition requiring evaluation and treatment by a qualified mental health professional. As with all other psychiatric conditions, it requires an individualized approach to treatment. Parents of children with DMDD and the children affected will need caring support throughout the evaluation and treatment process. While disruptive mood dysregulation disorder is only diagnosed in adolescence, its effects can be long-lasting. Proper evaluation and treatment are necessary to provide children with the support and resources they need to manage their mental health into adulthood. Parents and caretakers should never ignore disruptive mood dysregulation disorder symptoms, and they should always take them seriously.

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Written by Jessica Dzubak, MSN, RN

Jessica Dzubak, MSN, RN, is the Director of Nursing Practice for the Ohio Nurses Association. She is also a freelance writer specializing in the healthcare industry. She enjoys her two dogs, which add commentary to her articles by laying their heads across the keyboard while she’s writing. Visit her website at www.nursejessicawrites.com.

References

National Institute of Mental Health. (n.d.). Disruptive mood dysregulation disorder: The basics. Retrieved November 24, 2020 https://www.nimh.nih.gov/health/publications/disruptive-mood-dysregulation-disorder/index.shtml

American Academy of child and adolescent psychiatry. (2019 May). Disruptive mood dysregulation disorder (DMDD). Retrieved November 24, 2020 https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Disruptive-Mood-Dysregulation-Disorder-_DMDD_-110.aspx

American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed, text revision). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596.

Rao, U. (2014). DSM-5: Disruptive mood dysregulation disorder. Asian Journal of Psychiatry. 11.https://doi.org/10.1016/j.ajp.2014.03.002

National Institute of Mental Health. (2017). Disruptive mood dysregulation disorder. Retrieved November 24, 2020https://www.nimh.nih.gov/health/topics/disruptive-mood-dysregulation-disorder-dmdd/disruptive-mood-dysregulation-disorder.shtml

Copeland, W., Shanahan, L., Egger, H., Angold, A., & Costello, E. (2014). Adult diagnostic and functional outcomes of DSM-5 disruptive mood dysregulation disorder. American Journal of Psychiatry. 171(6). 668-674.10.1176/appi.ajp.2014.13091213