Disruptive Mood Dysregulation Disorder

What is it?

Children with disruptive mood dysregulation disorder (DMDD) have severe, frequent temper tantrums that interfere with their ability to function at home, in school or with their friends. Children with DMDD are more likely to develop problems with depression or anxiety.

Signs and Symptoms

Signs and symptoms include severe temper outbursts at least three times a week; a sad, irritable or angry mood almost every day; and a reaction that’s bigger than expected. The child must be at least 6 years old and have symptoms that began prior to age 10 and have been present for a year. The child must also have trouble in more than one setting, like home, school and/or with friends. DMDD more accurately categorizes some children who had previously been diagnosed with pediatric bipolar disorder. They are at elevated risk for depression and anxiety as adults. Unlike pediatric bipolar disorder, DMDD may occur more often in boys than girls.

Diagnosis and Treatment

DMDD encompasses severe temper outbursts that occur, on average, three+ times per week. In addition, the child’s mood between outbursts must be consistently angry or irritable. For diagnosis of DMDD, a child must experience this pattern of frequent outbursts, plus consistent anger or irritability between outbursts, for 12 or more months. During this 12-month period, the child must show symptoms consistently, meaning that he does not experience a break of three or more months without symptoms of DMDD. The diagnosis of DMDD should not be made before age 6 or after age 18, and the onset of symptoms typically takes place before age 10.

Medication, psychotherapy and a combination of the two may be used as treatments.

What are the risk factors for children?

Some of the symptoms associated with DMDD are also present in other child psychiatric disorders, such as depression, bipolar disorder and oppositional defiant disorder. Some children with DMDD also have a second disorder, such as problems with attention or anxiety. It’s important to get a comprehensive evaluation by a trained and qualified mental health professional.

The treatment for DMDD is individualized to the needs of the child. It may include therapy, as well as work with the child’s family and/or school. Medication may help specific symptoms.