Prevalence, Comorbidity, and Correlates of DSM-5 Proposed Disruptive Mood Dysregulation Disorder
Abstract
Objective
Method
Results
Conclusions
Method
Participants
Characteristic | Duke Preschool Anxiety Study | Great Smoky Mountains Study | Caring for Children in the Community |
---|---|---|---|
Total subjects | 918 | 1,420 | 920 |
Total observations | 918 | 5,336 | 1,627 |
Informant | Parent only | Parent and self-report | Parent and self-report |
Age (years) | mean=3.9 (SD=1.3, range=2–6) | mean=13.7 (SD=2.0, range=9–17) | mean=14.2 (SD=3.4, range=9–17) |
% Female | 51.8 | 49.2 | 50.0 |
Race/Ethnicity | |||
White | 62.1% | 89.8% | 41.0% |
African American | 37.5% | 6.4% | 53.8% |
Native American | 3.8% | ||
Other | 0.5% | 5.2% | |
Interview | Preschool Age Psychiatric Assessment | Child and Adolescent Psychiatric Assessment | Child and Adolescent Psychiatric Assessment |
The Duke Preschool Anxiety Study.
The Great Smoky Mountains Study.
Caring for Children in the Community.
Measures
Disruptive mood dysregulation disorder.
Psychiatric comorbidities.
Impairments.
Sociodemographic correlates.
Service use.
Analytic Strategy
Results
Prevalence Rates
Duke Preschool Anxiety Study (N=918) | Great Smoky Mountains Study (N=5,336) | Caring for Children in the Community (N=1,627) | ||||
---|---|---|---|---|---|---|
Criterion | N | % | N | % | N | % |
A. Severe tantrums | 769 | 80.8 | 2,465 | 45.7 | 871 | 49.0 |
B. Frequency | 182 | 17.7 | 514 | 7.1 | 140 | 6.3 |
C. Negative mood | 268 | 21.1 | 798 | 12.8 | 179 | 8.2 |
D. Duration | 92 | 5.9 | 221 | 2.8 | 42 | 1.5 |
E. Multiple settings | 116 | 10.1 | 229 | 2.8 | 101 | 3.8 |
Excluding onset criterion | 99 | 1.2 | 33 | 0.9 | ||
Excluding duration criterion | 143 | 1.6 | 47 | 1.2 | ||
Full criteria | 58 | 3.3 | 89 | 1.1 | 31 | 0.8 |
Comorbidity
Rate of DMDD (%) | Rate of Diagnosis (%) | ||||||
---|---|---|---|---|---|---|---|
Comorbidity | Diagnosis | No Diagnosis | DMDD | No DMDD | Odds Ratio | 95% CI | p |
Duke Preschool Anxiety Study | |||||||
Depressive | 23.0 | 2.9 | 12.4 | 1.4 | 9.9 | 4.1–23.7 | <0.0001 |
Anxiety | 7.5 | 1.3 | 72.9 | 30.7 | 6.1 | 1.9–19.0 | 0.002 |
ODD | 37.7 | 1.1 | 67.7 | 3.8 | 52.9 | 17.1–163.8 | <0.0001 |
Conduct disorder | 9.7 | 2.8 | 22.1 | 7.0 | 3.8 | 1.5–9.3 | 0.004 |
ADHD | 23.5 | 2.4 | 30.8 | 3.4 | 12.6 | 4.0–39.6 | <0.0001 |
Great Smoky Mountains Study | |||||||
Depressive | 15.6 | 0.8 | 32.7 | 2.1 | 23.5 | 9.9–56.1 | <0.0001 |
Anxiety | 5.5 | 1.0 | 9.3 | 1.8 | 5.2 | 1.2–22.9 | 0.03 |
ODD | 23.3 | 0.5 | 57.4 | 2.2 | 61.0 | 27.7–134.4 | <0.0001 |
Conduct disorder | 10.9 | 0.9 | 23.1 | 2.1 | 11.9 | 3.4–41.0 | <0.0001 |
ADHD | 9.2 | 1.1 | 6.3 | 0.7 | 7.6 | 2.9–19.7 | <0.0001 |
Caring for Children in the Community | |||||||
Depressive | 11.8 | 0.8 | 35.8 | 3.2 | 16.3 | 6.3–42.1 | <0.0001 |
Anxiety | 2.5 | 1.1 | 7.7 | 3.6 | 2.2 | 0.6–8.2 | 0.25 |
ODD | 27.0 | 0.4 | 70.6 | 2.3 | 103.0 | 40.1–264.2 | <0.0001 |
Conduct disorder | 5.3 | 1.0 | 18.8 | 4.0 | 4.4 | 1.2–15.3 | 0.02 |
ADHD | 4.3 | 1.1 | 9.4 | 1.8 | 2.9 | 0.4–23.3 | 0.32 |
Impairment, Service Use, and Sociodemographic Correlates
Great Smoky Mountains Study | Caring for Children in the Community | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Criterion | DMDD (%) | No DMDD (%) | Odds Ratio | 95% CI | p | DMDD (%) | No DMDD (%) | Odds Ratio | 95% CI | p |
Impairment | ||||||||||
Parental relations | 57.3 | 7.0 | 17.2 | 8.2–36.1 | <0.0001 | 64.4 | 11.1 | 12.3 | 5.2–29.2 | <0.0001 |
Sibling relations | 25.4 | 3.8 | 7.7 | 2.6–22.7 | 0.0002 | 66.2 | 6.8 | 24.3 | 10.7–55.3 | <0.0001 |
Teacher relations | 16.5 | 2.0 | 8.5 | 2.7–26.8 | 0.0003 | 55.1 | 4.5 | 20.9 | 10.2–42.7 | <0.0001 |
School suspension | 35.1 | 4.2 | 11.4 | 4.4–30.0 | <0.0001 | 38.3 | 8.6 | 6.0 | 2.8–12.9 | <0.0001 |
Service use | ||||||||||
Mental health | 31.5 | 6.0 | 6.5 | 2.6–16.3 | <0.0001 | 39.8 | 4.7 | 13.8 | 4.7–40.5 | <0.0001 |
General medical | 8.0 | 3.3 | 2.6 | 1.3–5.1 | 0.006 | 0.0 | 2.4 | |||
School system | 26.0 | 7.5 | 4.1 | 1.7–9.7 | 0.002 | 37.5 | 8.7 | 6.8 | 2.2–20.5 | 0.0008 |
Child welfare | 15.4 | 1.3 | 13.1 | 3.6–47.9 | 0.0001 | 5.8 | 0.6 | 10.2 | 1.4–75.3 | 0.02 |
Juvenile justice | 8.8 | 1.8 | 4.1 | 0.6–27.7 | 0.15 | 28.4 | 1.0 | 16.1 | 4.6–56.5 | <0.0001 |
Any | 54.2 | 18.0 | 4.5 | 2.1–9.7 | 0.001 | 60.8 | 14.0 | 9.6 | 3.2–28.2 | <0.0001 |
Sociodemographic | ||||||||||
Impoverished | 42.9 | 19.0 | 3.0 | 1.3–6.9 | 0.01 | 66.2 | 31.9 | 4.1 | 1.6–10.4 | 0.003 |
Single-parent family | 40.0 | 23.7 | 2.2 | 1.0–4.9 | 0.05 | 26.1 | 14.7 | 2.0 | 0.8–48.0 | 0.12 |
Low parent education | 19.4 | 17.3 | 1.3 | 0.5–3.2 | 0.61 | 61.8 | 42.7 | 2.1 | 0.9–4.9 | 0.09 |
Discussion
Conclusions
References
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