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Irritability in Children - Disruptive Mood Dysregulation Disorder


Leibenluft: So within the ten or 15 years there was this movement within child psychiatry. There were a number of important leaders in the field who had the idea that children with very severe irritability should be given the diagnosis of bipolar disorder. That this was a form of manic depressive illness in children. That children who are very irritable all of the time, this was how bipolar disorder was presenting. And this was a controversial idea. We and others did a series of studies on it.  And basically what we found is that these children, these irritable children, do not grow up to have bipolar disorder. They don’t grow up to have manic episodes, which is really the core part of bipolar disorder. Instead, these children grow up to have increased risk for anxiety and for depression. What’s called unipolar depression, just major depression, not bipolar depression.  So, for this and other reasons, in the DSM-5 there is a new diagnosis created called Disruptive Mood Dysregulation Disorder.  It’s called DMDD for short. And these children really fit much better into that diagnosis than they do into bipolar disorder.