Disruptive Mood Dysregulation Disorder: symptoms and treatment.

This diagnostic label applied to children has been criticized for labeling behaviors.

Irritability and outbursts of rage in these children is one of the most recurrent reasons in consultations and psychology centers. Although these reactions are relatively common in these stages, their chronicity and intensity must be controlled.

When these attacks are too accentuated and occur too often they can be diagnosed as a Disruptive Mood Dysregulation Disorder.. Below we discuss its symptoms and treatment, as well as the controversy surrounding this concept.

What is Disruptive Mood Dysregulation Disorder?

Disruptive Mood Dysregulation Disorder (MDDDD) is a relatively new term in clinical psychology and psychiatry that refers to a child's disturbance of the child's mood state.. During this the child shows manifestations of chronic irritability and mood states that are disproportionate to the situation.

Although these symptoms can also be seen in a wide variety of childhood psychological disorders such as bipolar disorder, oppositional defiant disorder (NPD) or Attention Deficit Hyperactivity Disorder (ADHD), the idea of creating a new concept such as ADHD was founded with the aim of being able to include temper tantrums and outbursts of anger in the diagnosis.

The addition of this new label for child behavior to the DSM-V has been widely criticized both by professionals in psychology and pedagogy, as well as by researchers in behavioral sciences. One of these criticisms is the questioning of whether it is really necessary to create more labels for children's behaviorThe labels tend to create a stigma for the child on both a personal and social level.

On the other hand, the diagnostic criteria do not take into account the child's family, school or social context, which can have a great influence on the child's behavior.which can exert a great influence on the child's mood and behavior, and may be the real cause of these explosions of anger and rage.

Finally, it has been questioned whether this disorder was substantially different from the others already described. However, according to some studies there is a disparity in etiology, evolution and neurobiological basis.

Differences with pediatric bipolar disorder

There are many cases of alleged disruptive mood dysregulation disorders that, due to the similarity between the symptomatology of both conditions, have been diagnosed as pediatric bipolar disorder.

The main difference between the two is that, whereas in bipolar disorder the child has well-defined episodes of depressive mood and mania, children diagnosed with ADHD do not experience these different mood episodes in a depressive and manic manner. do not experience these different episodes in such a precise or delimited way. or delimited manner.

In bipolar, specific episodes are interspersed with moments of euthymia, whereas in ADHD the periods of change are much more persistent and random.

Symptomatology of ADPDD

In order to make a satisfactory diagnosis of TDDEA, without burdening the child with unnecessary labels, the fifth volume of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes the diagnostic criteria for this disorder, including its symptoms and exceptions. These criteria are:

• Symptoms present in boys or girls between 6 and 18 years of age. of age.
• Severe and recurrent outbursts of anger in response to common stressors. These outbursts must be incongruent with the child's developmental level, the mood between anger outbursts must be irritable or irascible, and the average number of anger outbursts must be at least three times a week.
• Symptoms begin before 10 years of age.
• Persistent symptomatology for at least 12 months.
• Symptoms have not have not disappeared for three or more months in a row..
• Symptoms must appear in at least two of the following contexts: home, school, social context; being severe in at least one of them.
• The symptomatology cannot be better explained by any other medical condition, nor by the consumption of any drug or substance.
• The symptoms do not do not correspond to the criteria of a manic or hypomanic episode for more than one day. for more than one day.
• The symptoms do not meet the criteria for a major depressive episode.

It is necessary to specify that this diagnosis can in no case be made before the age of 6 years, since in these stages tantrums and outbursts of anger are habitual and normative.

On the other hand, the DSM-V specifies the impossibility of this disorder occurring at the same time as bipolar disorder, oppositional defiant disorder or intermittent explosive disorder.

Effects and consequences of TDDEA

According to evaluations and studies in the field of child psychology, it can be seen that approximately 80% of children under 6 years of age manifest tantrums in a more or less recurrent manner, becoming severe in only 20% of the cases.

For this anger or aggressiveness to be considered pathological, it must interfere with daily life. it must interfere in the child's daily life, as well as in his or her academic performance and daily family dynamics. As for the family environment, this disorder tends to generate a great impotence and sense of disorientation in the parents of the affected children, since they are unable to manage or control the behavior and actions of the child; fearing to impose punishments that are too rigid or on the contrary too lax.

As far as the child is concerned, the irascible behavior ends up affecting the child's relationship with peers.The children's parents do not understand the reason for their behavior. In addition, the levels of frustration they feel are so high that their attention span eventually decreases, hindering their academic progress.

Treatment

Due to the novelty of the concept, the treatment of ADHD is still being researched and developed by clinicians. by clinicians. However, the main protocol for intervention in these cases includes the combination of drugs with psychological therapy.

The medication of choice is usually stimulant medication or Antidepressant medication, while psychotherapy consists of a behavioral analysis applied to the patient.. In addition, the active role of the parents in the treatment is emphasized, since they must learn to manage the changes in the child's mood in the best possible way.

The pharmacological treatment of disruptive mood dysregulation disorder is another of the points for which this condition has received numerous criticisms, questioning the real need to medicate children.