Sociodemographic and Clinical Features of Disruptive Mood Dysregulation Disorder: A Chart Review.
OBJECTIVE
Disruptive mood dysregulation disorder (DMDD) is a novel diagnosis listed in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) to encompass chronic and impairing irritability in youth, and to help its differentiation from bipolar disorders. Because it is a new entity, treatment guidelines, as well as its sociodemographic and clinical features among diverse populations, are still not elucidated. Here, DMDD cases from three centers in Turkey are reported and the implications are discussed.


METHODS
The study was conducted at the Abant Izzet Baysal University Medical Faculty Department of Child and Adolescent Psychiatry (Bolu), and American Hospital and Bengi Semerci Institute (Istanbul) between August 2014 and October 2014. Records of patients were reviewed and features of patients who fulfilled criteria for DMDD were recorded. Data were analyzed with SPS Version 17.0 for Windows. Descriptive analyses, χ(2) test, and Mann-Whitney U test were used for analyses. Diagnostic consensus was determined via Cohen's κ constants. p was set at 0.01.


RESULTS
Thirty-six patients (77.8 % male) fulfilled criteria for DMDD. κ value for consensus between clinicians was 0.68 (p = 0.00). Mean age of patients was 9.0 years (S.D. = 2.5) whereas the mean age of onset for DMDD symptoms was 4.9 years (S.D. = 2.2). Irritability, temper tantrums, verbal rages, and physical aggression toward family members were the most common presenting complaints.


CONCLUSIONS
Diagnostic consensus could not be reached for almost one fourth of cases. Most common reasons for lack of consensus were problems in clarification of moods of patients in between episodes, problems in differentiation of normality and pathology (i.e., symptoms mainly reported in one setting vs. pervasiveness), and inability to fulfill frequency criterion for tantrums.
1 Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University Medical Faculty , Bolu, Turkey .
Evren
E
Tufan
1 Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University Medical Faculty , Bolu, Turkey .
Zehra
Z
Topal
1 Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University Medical Faculty , Bolu, Turkey .
Nuran
N
Demir
2 Department of Psychiatry, Koc University Medical Faculty , Istanbul, Turkey .
Sarper
S
Taskiran
1 Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University Medical Faculty , Bolu, Turkey .
Uğur
U
Savci
1 Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University Medical Faculty , Bolu, Turkey .
Mehmet Akif
MA
Cansiz
3 Department of Child and Adolescent, Bengi Semerci Institute , Istanbul, Turkey .
Bengi
B
Semerci
D000293:Adolescent; D000374:Aggression; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D014421:Turkey