The core characteristic of DMDD
is chronic, severe and persistent irritability.
has a prevalence of 2%-5% and occurs mostly in boys, whereas bipolar disorder affects boys and girls equally and affects less than 1% prior to adolescence.
Beyond the scientific evidence, there is an observed clinical need for a DMDD
diagnosis since current diagnostic criteria do not accurately capture the symptoms and behaviors of these children.
requires that there be severe and recurrent temper outbursts that can be verbal or physical and are grossly out of proportion to the situation, happening at least three times a week for the past year.
The findings suggest that these patients who lack signs of elevated mood and meet DMDD
criteria routinely get diagnosed with bipolar I disorder, have a more problematic hospital stay, and have more symptoms at discharge, Dr.
"takes you into areas of judgment that many people are uncomfortable with," such as deciding whether outbursts by children are "grossly out of proportion" to the situation, Dr.
"is just as likely to be abused as bipolar disorder, because it doesn't capture the vast majority of kids with explosive outbursts," she added.
Once a diagnosis of severe mood disorder is suspected (and when bipolar or DMDD
is considered likely), the management of one of these kids is probably beyond the scope of a typical primary care practice.
I belong to the third group, those who say we do not sufficiently understand this behavior in children whether we call it bipolar disorder or DMDD
Here's the problem: Many children with explosive outbursts have depression and dysthymia, or PTSD," or some other exclusionary problem, or don't meet all of the DMDD