Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder

Abstract

Objective: No empirical studies on the DSM-5 proposed disruptive mood dysregulation disorder have yet been published. This study estimated prevalence, comorbidity, and correlates of this proposed disorder in the community.

Method: Prevalence rates were estimated using data from three community studies involving 7,881 observations of 3,258 participants from 2 to 17 years old. Disruptive mood dysregulation disorder was diagnosed using structured psychiatric interviews.

Results: Three-month prevalence rates for meeting criteria for disruptive mood dysregulation disorder ranged from 0.8% to 3.3%, with the highest rate in preschoolers. Rates dropped slightly with the strict application of the exclusion criterion, but they were largely unaffected by the application of onset and duration criteria. Disruptive mood dysregulation co-occurred with all common psychiatric disorders. The highest levels of co-occurrence were with depressive disorders (odds ratios between 9.9 and 23.5) and oppositional defiant disorder (odds ratios between 52.9 and 103.0). Disruptive mood dysregulation occurred with another disorder 62%-92% of the time, and it occurred with both an emotional and a behavioral disorder 32%-68% of the time. Affected children displayed elevated rates of social impairments, school suspension, service use, and poverty.

Conclusions: Disruptive mood dysregulation disorder is relatively uncommon after early childhood, frequently co-occurs with other psychiatric disorders, and meets common standards for psychiatric "caseness." This disorder identifies children with severe levels of both emotional and behavioral dysregulation.

Figure 1

These charts indicate the rates of individuals with disruptive mood dysregulation disorder only, disruptive mood dysregulation disorder plus emotional disorders, disruptive mood dysregulation disorder plus behavioral disorders or disruptive mood dysregulation disorder plus both emotional and behavioral disorders in the Duke Preschool Anxiety Study (A), Great Smoky Mountains Study (B), and Caring for Children in the Community study (C).