Will disruptive mood dysregulation disorder reduce false diagnosis of bipolar disorder in children?
OBJECTIVE
The frequency of diagnosis of bipolar disorder has risen dramatically in children and adolescents. The DSM-V Work Group has suggested a new diagnosis termed disruptive mood dysregulation disorder (DMDD) (formerly temper dysregulation disorder with dysphoria) to reduce the rate of false diagnosis of bipolar disorder in young people. We sought to determine if the application of the proposed diagnostic criteria for DMDD would reduce the rate of diagnosis of bipolar disorder in children.


METHODS
Eighty-two consecutively hospitalized children, ages 5 to 12 years, on a children's inpatient unit were rigorously diagnosed using admission interviews of the parents and the child, rating scales, and observation over the course of hospitalization.


RESULTS
Overall, 30.5% of inpatient children met criteria for DMDD by parent report, and 15.9% by inpatient unit observation. Fifty-six percent of inpatient children had parent-reported manic symptoms. Of those, 45.7% met criteria for DMDD by parent-report, though only 17.4% did when observed on the inpatient unit.


CONCLUSIONS
Although DMDD does decrease the rate of diagnosis of bipolar disorder in children, how much depends on whether history or observation is used.
Department of Psychiatry and Behavioral Science, School of Medicine, State University of New York at Stony Brook, NY, USA.
David M
DM
Margulies
Sheldon
S
Weintraub
Joann
J
Basile
Paul J
PJ
Grover
Gabrielle A
GA
Carlson
D000374:Aggression / Q000523:psychology; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D019964:Mood Disorders / Q000145:classification / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales