title: An exploratory clinical study of disruptive mood dysregulation disorder in children and adolescents from India.
abstract: BACKGROUND
  Children with chronic non-episodic irritability were frequently diagnosed as suffering from pediatric bipolar disorder. Therefore in DSM-5 a new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) was included for such children.
  
  
  OBJECTIVE
  This study aimed to identify DMDD in children and adolescents in Indian child and adolescent psychiatry clinic and elicit its phenomenology and co-morbidities.
  
  
  METHODS
  Children of 6-16 years, presenting with irritability for more than one year were assessed using DSM 5 diagnostic criteria to make a diagnosis of DMDD. Severity of irritability was assessed using Affective Reactivity index (ARI). Co-morbidities were screened on Kiddie Schedule for Affective Disorders and Schizophrenia present and lifetime version (KSADS-PL) and diagnosed as per DSM-IV TR criteria. Overall behavioral problems were assessed on Conner's parent symptom questionnaire (CPSQ) and impairment in functioning on children's global assessment of functioning scale(C-GAS).
  
  
  RESULTS
  21 subjects were diagnosed with DMDD. Majority of the subjects (15, 71.4%) were in the age group 6-12 years (mean age11.1±2.9 years) and were males (16, 76.2%). Most common presenting complaints were, frequent irritability and anger outbursts in 21 (100%) and inattention towards studies in 20 (95.2%) subjects. Most of the subjects (18, 85.7%) had moderate to severe irritability. 13 (61.9%) subjects had co-morbidities. Mean CGAS was 46.1±6.9.
  
  
  CONCLUSIONS
  DMDD can be diagnosed in Indian children using DSM 5 criteria. Such children presented with complaints of irritability and problems in studies. They commonly had co-morbidities and had moderate impairment of functioning.
authors.affiliation: Department of Psychiatry, King George Medical University, Lucknow 226003, Uttar Pradesh, India. Electronic address: drrashmikgmu06@gmail.com.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Tiwari
authors.affiliation: Department of Psychiatry, King George Medical University, Lucknow 226003, Uttar Pradesh, India. Electronic address: drvivekagarwal06@gmail.com.
authors.forename: Vivek
authors.initials: V
authors.lastname: Agarwal
authors.affiliation: Department of Psychiatry, King George Medical University, Lucknow 226003, Uttar Pradesh, India. Electronic address: amitarya.11kgmu@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Arya
authors.affiliation: Department of Psychiatry, King George Medical University, Lucknow 226003, Uttar Pradesh, India. Electronic address: gpawan2008@gmail.com.
authors.forename: Pawan Kumar
authors.initials: PK
authors.lastname: Gupta
authors.affiliation: Department of Psychiatry, King George Medical University, Lucknow 226003, Uttar Pradesh, India. Electronic address: poojapsy@gmail.com.
authors.forename: Pooja
authors.initials: P
authors.lastname: Mahour
mesh_terms: D000293:Adolescent; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000208:ethnology*; D002648:Child; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D019964:Mood Disorders / Q000208:ethnology*
keywords: Chronic irritability; Co-morbidities; DSM-5; Disruptive mood dysregulation disorder (DMDD); Phenomenology