Overview

Disruptive mood dysregulation disorder (DMDD) is a childhood disorder characterized by extreme irritability, anger, and frequent, intense temper outbursts. DMDD is a new diagnosis introduced in the Diagnostic and Statistical of Mental Disorders (DSM-V). It impacts children between the ages of 6 and 18.

Signs and Symptoms

 

DMDD symptoms typically begin before the age of 10. A child with DMDD experiences:

  • Irritable or angry mood most of the day, nearly every day
  • three or more severe temper outbursts (verbal or behavioral) on an average per week
  • Trouble functioning due to irritability in more than one place (e.g., home, school, with peers)
  • These symptoms must be present for 12 or more months

Risk Factors

Researchers are exploring risk factors and brain mechanisms of this disorder.

Treatment and Therapies

DMDD is a new diagnosis. Treatment is based on treating the symptoms of irritability and temper tantrums. These could be symptoms of attention deficit hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder, and major depressive disorder.

There are two major types of treatment are currently used to treat DMDD symptoms:

  • Medication
  • Psychological treatments
    • Psychotherapy
    • Parent training
    • Computer based training

Psychotherapy

Psychotherapy is the main stay of treatment and should be tried before starting the medications.

  • Cognitive-behavioral therapy, a type of psychotherapy, is commonly used to teach children and teens how to deal with thoughts and feelings that contribute to their feeling depressed or anxious. The therapy also teaches coping skills for regulating anger and ways to identify and re-label the distorted perceptions that contribute to outbursts.
  • Parent Training aims to help parents interact with a child in a way that will reduce aggression and irritable behavior and improve the parent-child relationship. Training also focuses on the importance of predictability, being consistent with children, and rewarding positive behavior.
  • Computer-based training Evidence suggests that irritable youth with DMDD may be prone to misperceiving ambiguous facial expressions as angry. There is preliminary evidence that computer-based training designed to correct this problem may help youth with DMDD or severe irritability.

Medication

Many medications used to treat children and adolescents with mental illness are effective in relieving symptoms.

Stimulants are medications that are commonly used to treat ADHD. There is evidence that, in children with irritability and ADHD, stimulant medications also decrease irritability.

Antidepressant medication is sometimes used to treat the irritability and mood problems associated with DMDD Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.

Atypical Antipsychotic medication may be prescribed for children with very severe temper outbursts that involve physical.