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Treatment in Psychiatry   |    
Disruptive Mood Dysregulation Disorder: A New Diagnostic Approach to Chronic Irritability in Youth
Amy Krain Roy, Ph.D.; Vasco Lopes, Psy.D.; Rachel G. Klein, Ph.D.
Am J Psychiatry 2014;171:918-924. doi:10.1176/appi.ajp.2014.13101301
View Author and Article Information

The authors report no financial relationships with commercial interests.

Supported by NIMH grant 1R01MH091140-01A1 and a generous gift from the Seevak Family Foundation.

From the Department of Psychology, Fordham University, Bronx, N.Y.; and the NYU Child Study Center, New York.

Address correspondence to Dr. Klein (rachel.klein@nyumc.org).

Copyright © 2014 by the American Psychiatric Association

Received October 02, 2013; Revised December 13, 2013; Accepted January 17, 2014.

Abstract

Disruptive mood dysregulation disorder (DMDD), a newcomer to psychiatric nosology, addresses the need for improved classification and treatment of children exhibiting chronic nonepisodic irritability and severe temper outbursts. In recent years, many of these children have been diagnosed with bipolar disorder, despite the lack of distinct mood episodes. This diagnostic practice has raised concerns, in part because of the escalating prescription of atypical antipsychotics. This article provides an overview of the limited literature on DMDD, including its history and relevant studies of assessment and treatment. A case study is included to illustrate key points, including diagnostic issues that clinicians may encounter when considering a diagnosis of DMDD.

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TABLE 1.Comparison of Diagnostic Criteria for Disruptive Mood Dysregulation Disorder (DMDD), Oppositional Defiant Disorder, and Intermittent Explosive Disordera
Table Footer Note

a Criteria are reprinted from American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC, APA, 2013. Copyright 2013, American Psychiatric Association. Used with permission.

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