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E-ISSN: 2687-3532
DSM-5 Distinction or ICD-11 Union for Disruptive Mood Dysregulation and Oppositional Defiant Disorders? A Cross-sectional Study
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Original Article
VOLUME: 30 ISSUE: 2
P: 172-180
July 2023

DSM-5 Distinction or ICD-11 Union for Disruptive Mood Dysregulation and Oppositional Defiant Disorders? A Cross-sectional Study

Turk J Child Adolesc Ment Health 2023;30(2):172-180
DOI: 10.4274/tjcamh.galenos.2022.73645
Baran Çalışgan 1
Zehra Hangül 2
Mehmet Karadağ 2
1. Kastamonu Eğitim ve Araştırma Hastanesi, Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kliniği, Kastamonu, Türkiye
2. Gaziantep Üniversitesi Tıp Fakültesi, Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Gaziantep, Türkiye
No information available.
No information available
Received Date: 19.08.2022
Accepted Date: 20.10.2022
Publish Date: 01.08.2023
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ABSTRACT

Objectives:

There is a diagnostic overlap between the symptom clusters of Disruptive Mood Dysregulation Disorder (DMDD) and Oppositional Defiant Disorder (ODD). In this study we aim to compare behavior problems in these two disorders as quantified by the Conners’ Parent Rating Scale scores.

Materials and Methods:

In a sample of 96 children between the ages of 8-12 who presented to Gaziantep University, Department of Child and Adolescent Psychiatry, Gaziantep, Turkey with irritability or anger outbursts and were diagnosed with either DMDD or ODD, we conducted a semi-structured clinical interview to assess comorbidities and we obtained Conners’ Parent Rating Scale Scores.

Results:

All those diagnosed with DMDD had comorbidities, and DMDD was associated with a higher frequency of comorbidities than ODD. The most common lifetime comorbidity was Attention Deficit and Hyperactivity Disorder with 96.0%. 96.0% of the cases diagnosed with DMDD also met the diagnostic criteria for ODD. Conners’ Scale results showed that there was a statistically significant difference between the two groups in terms of mean total score (p<0.05), which was 47.4±18.3 in the ODD group and 64.3±20.1 in the DMDD group. Regarding the subscale scores, these was a statistically significant difference among the groups in the Conduct Problems and Anxiety Subscales (p<0.05), which were higher in the DMDD group, whereas there was not a statistically significant in the other subscale scores (p>0.05).

Conclusion:

In our sample, DMDD was associated with more comorbid mental disorders, more severe behavioral and learning problems and anxiety symptoms when compared to ODD, but no difference was found in terms of impulsivity, hyperactivity, and psychosomatic symptoms. Our cross-sectional study, which compared two mental disorders with a diagnostic overlap, is significant in terms of the definitions of mental disorders in children with chronic irritability and anger outbursts.

References

1
Krieger FV, Leibenluft E, Stringaris A, Polanczyk GV. Irritability in children and adolescents: past concepts, current debates, and future opportunities. Braz J Psychiatry. 2013;35):S32-S39.
2
Evans SC, Burke JD, Roberts MC, Fite PJ, Lochman JE, de la Peña FR, Reed GM. Irritability in child and adolescent psychopathology: An integrative review for ICD-11. Clin Psychol Rev. 2017;53:29-45.
3
Hendrickson B, Girma M, Miller L. Review of the clinical approach to the treatment of disruptive mood dysregulation disorder. Int Rev Psychiatry. 2020;32:202-211.
4
Axelson D, Findling RL, Fristad MA, Kowatch RA, Youngstrom EA, Horwitz SM, Arnold LE, Frazier TW, Ryan N, Demeter C, Gill MK, Hauser-Harrington JC, Depew J, Kennedy SM, Gron BA, Rowles BM, Birmaher B. Examining the proposed disruptive mood dysregulation disorder diagnosis in children in the Longitudinal Assessment of Manic Symptoms study. J Clin Psychiatry. 2012;73:1342-1350.
5
Margulies DM, Weintraub S, Basile J, Grover PJ, Carlson GA. Will disruptive mood dysregulation disorder reduce false diagnosis of bipolar disorder in children?. Bipolar Disord. 2012;14:488-496.
6
Laporte PP, Matijasevich A, Munhoz TN, Santos IS, Barros AJD, Pine DS, Rohde LA, Leibenluft E, Salum GA. Disruptive Mood Dysregulation Disorder: Symptomatic and Syndromic Thresholds and Diagnostic Operationalization. J Am Acad Child Adolesc Psychiatry. 2021;60:286-295.
7
Rao P, Moore JK, Stewart R, Hood SD, Runions K, Zepf FD. Diagnostic inexactitude - Reframing and relabelling Disruptive Mood Dysregulation Disorder for ICD-11 does not solve the problem. Med Hypotheses. 2015;85:1035-1036.
8
Axelson D. Taking disruptive mood dysregulation disorder out for a test drive. Am J Psychiatry. 2013;170:136-139.
9
Lochman JE, Evans SC, Burke JD, Roberts MC, Fite PJ, Reed GM, de la Peña FR, Matthys W, Ezpeleta L, Siddiqui S, Elena Garralda M. An empirically based alternative to DSM-5’s disruptive mood dysregulation disorder for ICD-11. World Psychiatry. 2015;14:30-33.
10
Quy K, Stringaris A. Oppositional defiant disorder. IACAPAP E-textb child Adolesc Ment Heal Geneva Int Assoc Child Adolesc Psychiatry Allied Prof. 2012.
11
Mayes SD, Waxmonsky JD, Calhoun SL, Bixler EO. Disruptive Mood Dysregulation Disorder Symptoms and Association with Oppositional Defiant and Other Disorders in a General Population Child Sample. J Child Adolesc Psychopharmacol. 2016;26:101-106.
12
Cimino KR. Distinguishing disruptive mood dysregulation disorder from oppositional defiant disorder: The nuances of childhood depression and irritability. Diss. University of Hartford; 2022.
13
Goyette CH, Conners CK, Ulrich RF. Normative data on revised Conners Parent and Teacher Rating Scales. J Abnorm Child Psychol. 1978;6:221-236.
14
Dereboy C, Senol S, Sener S, Dereboy F. Validation of the Turkish versions of the short-form Conners’ teacher and parent rating scales. Turk Psikiyatri Derg. 2007;18:48-58.
15
Kaufman J, Birmaher B, Axelson D, Perepletchikova F, Brent D, Ryan N. The schedule for affective disorders and schizophrenia for school-age children–present and lifetime version for DSM5 (K-SADS-PL-DSM5). West Psychiatr Inst Clin Adv Cent Interv Serv Res Early Onset Mood Anxiety Disord Yale Univ Child Adolesc Res Educ Progr. Published online 2016.
16
Ünal F, Öktem F, Çetin Çuhadaroğlu F, Çengel Kültür SE, Akdemir D, Foto Özdemir D, Çak HT, Ünal D, Tıraş K, Aslan C, Kalaycı BM, Aydos BS, Kütük F, Taşyürek E, Karaokur R, Karabucak B, Karakök B, Karaer Y, Artık A. Reliability and Validity of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (K-SADS-PL-DSM-5-T). Turk Psikiyatri Derg. 2019;30:42-50.
17
Le J, Feygin Y, Creel L, Lohr WD, Jones VF, Williams PG, Myers JA, Pasquenza N, Davis DW. Trends in diagnosis of bipolar and disruptive mood dysregulation disorders in children and youth. J Affect Disord. 2020;264:242-248.
18
Brotman MA, Schmajuk M, Rich BA, Dickstein DP, Guyer AE, Costello EJ, Egger HL, Angold A, Pine DS, Leibenluft E. Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biol Psychiatry. 2006;60:991-997.
19
Tufan E, Topal Z, Demir N, Taskiran S, Savci U, Cansiz MA, Semerci B. Sociodemographic and Clinical Features of Disruptive Mood Dysregulation Disorder: A Chart Review. J Child Adolesc Psychopharmacol. 2016;26:94-100.
20
Mulraney M, Schilpzand EJ, Hazell P, Nicholson JM, Anderson V, Efron D, Silk TJ, Sciberras E. Comorbidity and correlates of disruptive mood dysregulation disorder in 6-8-year-old children with ADHD. Eur Child Adolesc Psychiatry. 2016;25:321-330.
21
Martin SE, Hunt JI, Mernick LR, DeMarco M, Hunter HL, Coutinho MT, Boekamp JR. Temper Loss and Persistent Irritability in Preschoolers: Implications for Diagnosing Disruptive Mood Dysregulation Disorder in Early Childhood. Child Psychiatry Hum Dev. 2017;48:498-508.
22
Bruno A, Celebre L, Torre G, Pandolfo G, Mento C, Cedro C, Zoccali RA, Muscatello MRA. Focus on Disruptive Mood Dysregulation Disorder: A review of the literature Psychiatry Res. 2019;279:323-330.
23
Sparks GM, Axelson DA, Yu H, Ha W, Ballester J, Diler RS, Goldstein B, Goldstein T, Hickey MB, Ladouceur CD, Monk K, Sakolsky D, Birmaher B. Disruptive mood dysregulation disorder and chronic irritability in youth at familial risk for bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2014;53:408-416.
24
Copeland WE, Angold A, Costello EJ, Egger H. Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J Psychiatry. 2013;170:173-179.
25
Freeman AJ, Youngstrom EA, Youngstrom JK, Findling RL. Disruptive Mood Dysregulation Disorder in a Community Mental Health Clinic: Prevalence. Comorbidity and Correlates J Child Adolesc Psychopharmacol. 2016;26:123-130.
26
Evans SC, Roberts MC, Keeley JW, Rebello TJ, de la Peña F, Lochman JE, Burke JD, Fite PJ, Ezpeleta L, Matthys W, Youngstrom EA, Matsumoto C, Andrews HF, Elena Medina-Mora M, Ayuso-Mateos JL, Khoury B, Kulygina M, Robles R, Sharan P, Zhao M, Reed GM. Diagnostic classification of irritability and oppositionality in youth: a global field study comparing ICD-11 with ICD-10 and DSM-5. J Child Psychol Psychiatry. 2021;62:303-312.