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Published Online: 1 February 2013

Prevalence, Comorbidity, and Correlates of DSM-5 Proposed Disruptive Mood Dysregulation Disorder

Abstract

The low prevalence rates in three large community samples of children (0.8% to 3.3%) for the new proposed diagnosis of disruptive mood dysregulation disorder suggest that the diagnosis will not be extensively applied to children with normal behavior. Although the core symptoms are common, the criteria regarding frequency, duration, and context exclude most children. The diagnosis is associated with high levels of social impairment, school suspension, service use, and poverty. It frequently co-occurs with other psychiatric conditions, especially oppositional defiant disorder and depressive disorders, but overlapped only partially with severe mood dysregulation, the research diagnosis on which it was based.

Abstract

Objective

No empirical studies on the DSM-5 proposed disruptive mood dysregulation disorder have yet been published. This study estimated prevalence, comorbidity, and correlates of this proposed disorder in the community.

Method

Prevalence rates were estimated using data from three community studies involving 7,881 observations of 3,258 participants from 2 to 17 years old. Disruptive mood dysregulation disorder was diagnosed using structured psychiatric interviews.

Results

Three-month prevalence rates for meeting criteria for disruptive mood dysregulation disorder ranged from 0.8% to 3.3%, with the highest rate in preschoolers. Rates dropped slightly with the strict application of the exclusion criterion, but they were largely unaffected by the application of onset and duration criteria. Disruptive mood dysregulation co-occurred with all common psychiatric disorders. The highest levels of co-occurrence were with depressive disorders (odds ratios between 9.9 and 23.5) and oppositional defiant disorder (odds ratios between 52.9 and 103.0). Disruptive mood dysregulation occurred with another disorder 62%–92% of the time, and it occurred with both an emotional and a behavioral disorder 32%–68% of the time. Affected children displayed elevated rates of social impairments, school suspension, service use, and poverty.

Conclusions

Disruptive mood dysregulation disorder is relatively uncommon after early childhood, frequently co-occurs with other psychiatric disorders, and meets common standards for psychiatric “caseness.” This disorder identifies children with severe levels of both emotional and behavioral dysregulation.

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Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 173 - 179
PubMed: 23377638

History

Received: 27 January 2012
Revision received: 26 April 2012
Revision received: 15 June 2012
Revision received: 31 July 2012
Accepted: 30 August 2012
Published online: 1 February 2013
Published in print: February 2013

Authors

Affiliations

William E. Copeland, Ph.D.
From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C.
Adrian Angold, M.R.C.Psych.
From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C.
E. Jane Costello, Ph.D.
From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C.
Helen Egger, M.D.
From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C.

Notes

Address correspondence to Dr. Copeland ([email protected]).

Funding Information

The authors report no financial relationships with commercial interests.Supported by NIMH grants MH-080230, MH-63970, MH-63671, MH-48085, MH-075766; National Institute on Drug Abuse grants DA/MH-11301, DA-011301, DA-016977, DA-011301; a NARSAD Early Career Award to Dr. Copeland; and the William T. Grant Foundation.

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