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Disruptive mood dysregulation disorder (DMDD) is one of the new categories in DSM-5 and is classified under the section of Depressive Disorders. This disorder is characterized by persistent irritable mood, and severe (i.e., out of proportion in intensity or duration) and frequent (i.e., three or more times per week) temper outbursts. These features should have been present for at least 1 year and began before age 10, although the diagnosis should not be made before age 6 or after age 18.

Little research has been done on DMDD itself. Most of what we know about severe irritability as a category comes from the research done on severe mood dysregulation (SMD; see Table 47–1). This is a category of severe irritability created by Leibenluft and colleagues (Leibenluft et al, 2003) as a means of empirically scrutinizing the notion that chronically irritable children may be suffering from bipolar disorder. SMD and DMDD overlap considerably with two main differences. One is that in SMD, the requirement is for persistent negative mood (Criterion 2), which may be either irritability or sadness, whereas in DMDD only irritability or anger qualifies. The other difference is that DMDD does not include a hyperarousal criterion (Criterion 3 in SMD).

Table 47–1Research Diagnostic Criteria for Severe Mood Dysregulation (SMD)

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