Exploring temperament and sleep patterns in disruptive mood dysregulation disorder among children and adolescents: implications for clinical practice.

Abstract

Background: Disruptive Mood Dysregulation Disorder (DMDD), characterized by severe irritability and temper outbursts, is a relatively new diagnosis included in the DSM-5. The study aimed to investigate the clinical characteristics, temperament, comorbidities, medication use, and sleep quality of children and adolescents diagnosed with DMDD and compare them with Major Depressive Disorder (MDD).

Methods: A total of 233 participants (DMDD: n = 106; MDD: n = 127) were assessed using the K-SADS-PL. Evaluation tools included the Children's Temperament and Character Inventory, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Strengths and Difficulties Child and Parent Form, Children's Depression Inventory for children, and sociodemographic form.

Results: The DMDD group scored significantly lower in harm avoidance, reward dependence, and cooperation than the MDD group (p ≤ 0.001, p ≤ 0.02, p ≤ 0.002, respectively). DMDD exhibits significantly lower levels of social skill-related temperament traits, such as empathy, compassion, and helpfulness. Furthermore, a higher proportion of patients in the DMDD group received antipsychotic, mood stabilizer, and stimulant medications during treatment.

Conclusion: Children and adolescents diagnosed with DMDD demonstrated significantly lower scores in anticipatory worry, fear of uncertainty, shyness, fatigability, sentimentality, dependence, empathy, and helpfulness compared to those with MDD. Conversely, they exhibited higher levels of impulsiveness, disorderliness, and self-acceptance. These findings underscore the necessity of evaluating and enhancing social skills and reward sensitivity in the clinical management of DMDD, as these distinct psychological and behavioral profiles suggest the need for more tailored therapeutic approaches.