Disruptive Mood Dysregulation Disorder in a Community Mental Health Clinic: Prevalence, Comorbidity and Correlates

Andrew J. Freeman, Eric A. Youngstrom, Jennifer K. Youngstrom, Robert L Findling

Research output: Contribution to journalArticle

Abstract

Objective: The revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) added a new diagnosis of disruptive mood dysregulation disorder (DMDD) to depressive disorders. This study examines the prevalence, comorbidity, and correlates of the new disorder, with a particular focus on its overlap with oppositional defiant disorder (ODD), with which DMDD shares core symptoms. Methods: Data were obtained from 597 youth 6-18 years of age who participated in a systematic assessment of symptoms offered to all intakes at a community mental health center (sample accrued from July 2003 to March 2008). Assessment included diagnostic, symptomatic, and functional measures. DMDD was diagnosed using a post-hoc definition from item-level ratings on the Schedule for Affective Disorders and Schizophrenia for School-Age Children that closely matches the DSM-5 definition. Caregivers rated youth on the Child Behavior Checklist. Results: Approximately 31% of youth met the operational definition of DMDD, and 40% had Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) diagnoses of ODD. Youth with DMDD almost always had ODD (odds ratio [OR] = 53.84) and displayed higher rates of comorbidity with attention-deficit/hyperactivity disorder (ADHD) and conduct disorder than youth without DMDD. Caregivers of youth with DMDD reported more symptoms of aggressive behavior, rule-breaking, social problems, anxiety/depression, attention problems, and thought problems than all other youth without DMDD. Compared with youth with ODD, youth with DMDD were not significantly different in terms of categorical or dimensional approaches to comorbidity and impairment. Conclusions: The new diagnosis of DMDD might be common in community mental health clinics. Youth with DMDD displayed more severe symptoms and poorer functioning than youth without DMDD. However, DMDD almost entirely overlaps with ODD and youth with DMDD were not significantly different than youth with ODD. These findings raise concerns about the potentially confusing effects of using DMDD in clinical settings, particularly given that DSM-5 groups DMDD with depressive disorders, but ODD remains a disruptive behavior disorder, potentially changing the decision-making framework that clinicians use to select treatments.

Original languageEnglish (US)
Pages (from-to)123-130
Number of pages8
JournalJournal of Child and Adolescent Psychopharmacology
Volume26
Issue number2
DOIs
StatePublished - Mar 1 2016

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Mood Disorders
Comorbidity
Mental Health
Attention Deficit and Disruptive Behavior Disorders
Diagnostic and Statistical Manual of Mental Disorders
Depressive Disorder
Caregivers
Community Mental Health Centers
Conduct Disorder
Symptom Assessment
Social Problems
Child Behavior
Attention Deficit Disorder with Hyperactivity
Checklist

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health

Cite this

Disruptive Mood Dysregulation Disorder in a Community Mental Health Clinic : Prevalence, Comorbidity and Correlates. / Freeman, Andrew J.; Youngstrom, Eric A.; Youngstrom, Jennifer K.; Findling, Robert L.

In: Journal of Child and Adolescent Psychopharmacology, Vol. 26, No. 2, 01.03.2016, p. 123-130.

Research output: Contribution to journalArticle

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