Disruptive Mood Dysregulation Disorder Flashcards
how many diagnostic criteria are there for DMDD
11
criterion A for DMDD
severe, recurrent TEMPER OUTBURSTS manifested verbally and/or behaviourally that are GROSSLY OUT OF PROPORTION in intensity or duration to the situation or provocation
criterion B for DMDD
the temper outbursts are inconsistent with developmental level
criterion C for DMDD
the temper outbursts occur, on average, THREE OR MORE TIMES per WEEK
criterion D for DMDD
the mood between temper outbursts is persistently IRRITABLE or ANGRY most of the day, early every day and is OBSERVABLE by others
criterion E for DMDD
criteria A-D have been present for 12 or MORE MONTH
throughout that time, the individual has not has a period lasting three or more consecutive months without ALL of the symptoms in critiera A-D
criterion F for DMDD
criteria A and D are present in at least 2/3 settings (i.e home, school, with peers) and are severe in at least one of those
criterion G for DMDD
the diagnosis should not be made for the first time before age 6 or after age 18
criterion H for DMDD
by history of observation the age at onset for criteria A-E is BEFORE age 10
criterion I for DMDD
there has never been a distinct period lasting more than ONE day during which the full symptom criteria, except duration, for a manic or hypomanic episode have been met
criterion J for DMDD
the behaviours do not occur exclusively during an episode of MDD and are not better explained by another mental disorder
*this dx CANNOT coexist with ODD, IED or bipolar disorder though it CAN coexist with others like MDD, ADHD, CD and SUD
*if kid meets criteria for both ODD and DMDD should ONLY get diagnosis of DMDD
criterion K for DMDD
symptoms not attributable to physiological effects of a substance or another medical or neurological condition
how often must the temper outbursts of DMDD occur to meet DSM criteria
at least 3 or more times per week (criterion C)
how long must a kid have been symptomatic with irritability and temper outbursts to meet duration criteria for DMDD in the DSM?
12+ months
*during that time, can not have had a period lasting 3 or more consecutive months without ALL of the symptoms in criteria A-D (temper outbursts that are inconsistent with developmental level occurring at least 3x per week and it irritable in between)
in how many settings must the DMDD symptoms occur to meet criteria
2/3
dx of DMDD cannot be made before what age
6
dx of DMDD cannot be made after what age
18
symptoms of DMDD must have started before what age to meet criteria
age 10
what is the core feature of DMDD
chronic, severe, persistent irritability
(with temper outbursts)
when do the outbursts associated with DMDD typically occur
in response to frustration
can be verbal or behavioural (i.e in form of aggression against property, self or others)
rates of DMDD appear to be higher in which populations
higher in males and school age children
(lower in females and adolescents)
what is the 6-12 month period prevalence of DMDD
2-5%
within what age range has the dx of DMDD been validated
6-18 years
what % of kids that present with severe, chronic irritability will have a presentation that continues to meet criteria for DMDD a year later
about 50%
it is common for severe, nonepisodic irritability to convert to bipolar disorder
rates of conversion are low to bipolar (more likely to develop unipolar depression/anxiety)
what is one reason children with DMDD have difficulty succeeding in school
because of their extremely low frustration tolerance
how do levels of dysfunction compare between children with bipolar disorder and those with DMDD
comparable generally
both cause severe severe disruption in the lives of the affected individuals and their families
dangerous behaviour, SI and SA, severe aggression and hospitalization are common in boh
ddx DMDD
bipolar disorders
ODD
ADHD
MDD
anxiety disorders
ASD
IED
what is the central feature that differentiates DMDD from bipolar disorder
the longitudinal course of the core symptoms–>
bipolar I and II are episodic, with episodes that can be clearly distinguishes from the child’s baseline
in DMD sx are persistent and present over many months though may wax and wane slightly
also there is so euphoric/elevated mood in DMDD
what distinguishes DMDD from ODD
the mood symptoms associated with DMDD are relatively rare in children with ODD
*MOST kids whose symptoms meet criteria for DMDD will also have a presentation that meets criteria for ODD –> but the reverse is not the case (in those with ODD, only 15% would also meet criteria for DMDD)
can you diagnose ODD and DMDD in the same kid?
no–> if criteria for both are met, then dx is DMDD
can you diagnose both DMDD and IED in the same kid?
no
are there any FDA approved medications for use in DMDD
no
describe management of DMDD
should focus on helping children and teens improve emotional dysregulation through parental, school and professional support
social skills training may also be helpful
