title: [The Severe Chronic Irritability Concept: A clinical dimension to consider in child and adolescent].
abstract: BACKGROUND
  For a decade, the concept of irritability has known a renewed interest in infant and child psychopathology. Indeed, longitudinal follow-up studies clearly highlighted their predictive value - in the short, medium and long terms - of a broad field of behavioral disorders and emotion dysregulation. This dimensional and transnosographic approach of irritability, coupled with the latest neuroscience data, points out that irritability could be the equivalent of a psychopathological marker, covering both a neurobiological, cognitive and emotional component. It is a major challenge today to better understand the developmental sequence of severe chronic irritability and its predictive influence on the etiology of mental disorders from childhood to adulthood.
  
  
  METHODS
  We briefly review here the latest current data on this topic.
  
  
  RESULTS
  The important point is that chronic and non-episodic irritability in children, associated with strong emotional sensitivity to negative events and frequent access of anger, could have a predictive value for progression to anxiety disorder or severe mood disorder but not to bipolar disorder as it was believed until now. The risk of developing a bipolar disorder would be more frequently correlated with the notion of transient and episodic irritability in a context of previous family history of bipolar disorder.
  
  
  CONCLUSIONS
  Further studies are expected to narrow the discriminative validity of this notion of severe irritability and confirm or not its relevance as a major clinical criterion of Severe Mood Disorders in children and adolescents introduced in the last version of DSM (DSM-5).
authors.affiliation: Service psychopathologie du développement, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France; Laboratoire L2C2 UMR 5304 CNRS, université Claude-Bernard-Lyon 1, 69677 Bron, France. Electronic address: pierre.fourneret@chu-lyon.fr.
authors.forename: P
authors.initials: P
authors.lastname: Fourneret
authors.affiliation: Service psychopathologie du développement, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Desombre
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry / Q000379:methods; D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000175:diagnosis / Q000473:pathology / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D002648:Child; D002665:Child Psychiatry / Q000379:methods; D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D007508:Irritable Mood / Q000502:physiology*; D019964:Mood Disorders / Q000175:diagnosis / Q000473:pathology* / Q000523:psychology; D062706:Prodromal Symptoms; D012720:Severity of Illness Index
keywords: Bipolar disorder; Child psychopathology; Chronic severe irritability; DSM-5; Development; Développement; Irritabilité sévère chronique; Psychopathologie de l’enfant; Severe mood disorder; Trouble bipolaire; Trouble sévère de régulation de l’humeur