An exploratory clinical study of disruptive mood dysregulation disorder in children and adolescents from India

Asian J Psychiatr. 2016 Jun;21:37-40. doi: 10.1016/j.ajp.2016.02.005. Epub 2016 Feb 12.


Background: Children with chronic non-episodic irritability were frequently diagnosed as suffering from pediatric bipolar disorder. Therefore in DSM-5 a new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) was included for such children.

Aims: This study aimed to identify DMDD in children and adolescents in Indian child and adolescent psychiatry clinic and elicit its phenomenology and co-morbidities.

Methods: Children of 6-16 years, presenting with irritability for more than one year were assessed using DSM 5 diagnostic criteria to make a diagnosis of DMDD. Severity of irritability was assessed using Affective Reactivity index (ARI). Co-morbidities were screened on Kiddie Schedule for Affective Disorders and Schizophrenia present and lifetime version (KSADS-PL) and diagnosed as per DSM-IV TR criteria. Overall behavioral problems were assessed on Conner's parent symptom questionnaire (CPSQ) and impairment in functioning on children's global assessment of functioning scale(C-GAS).

Results: 21 subjects were diagnosed with DMDD. Majority of the subjects (15, 71.4%) were in the age group 6-12 years (mean age11.1±2.9 years) and were males (16, 76.2%). Most common presenting complaints were, frequent irritability and anger outbursts in 21 (100%) and inattention towards studies in 20 (95.2%) subjects. Most of the subjects (18, 85.7%) had moderate to severe irritability. 13 (61.9%) subjects had co-morbidities. Mean CGAS was 46.1±6.9.

Conclusion: DMDD can be diagnosed in Indian children using DSM 5 criteria. Such children presented with complaints of irritability and problems in studies. They commonly had co-morbidities and had moderate impairment of functioning.

Keywords: Chronic irritability; Co-morbidities; DSM-5; Disruptive mood dysregulation disorder (DMDD); Phenomenology.

MeSH terms

  • Adolescent
  • Attention Deficit and Disruptive Behavior Disorders / ethnology*
  • Child
  • Female
  • Humans
  • India / ethnology
  • Male
  • Mood Disorders / ethnology*