Disruptive mood dysregulation disorder (DMDD) in psychiatric inpatient child admissions: Prevalence among consecutive admissions and in children receiving NOS diagnoses

Background

Many children present with uncontrollable outbursts that present diagnostic challenges. Disruptive mood dysregulation disorder (DMDD) is a diagnosis that may capture their behavior. We examined the prevalence of DMDD in a series of 100 child discharges from inpatient care after the introduction of DSM-5 and in 100 children who received diagnoses of mood or bipolar disorder NOS prior to the advent of DSM-5.

Methods

All children were re-diagnosed with a retrospective chart review procedure. In the first sample, 100 consecutive discharges were reviewed. In the second study, children seen prior to the release from DSM-5 had their charts reviewed. The reviews addressed the presence of DMDD, as well as other conditions that may be co-morbid with DMDD.

Results

18 of the 100 consecutively discharged children (18 %) received a retrospective diagnosis of DMDD and 9 (50 %) received a comorbid diagnosis of major depression. Only 4 of the 18 children had a discharge diagnosis of DMDD. For the 100 children with NOS diagnoses prior to DSM-5, 37 (37 %) received retrospective diagnosis of DMDD. The major specific feature of DMDD was the higher frequency of temper outbursts. Longer length of stay and higher discharge GAF scores were also seen

Discussion

DMDD was present in approximately the same proportion of children as previous studies, in samples admitted before and after DSM-5. Clinical diagnoses of mood disorders NOS are common in children who meet criteria for DMDD and DMDD diagnoses still do not appear to be given to many children who meet the criteria.