According to a recent article in The Wall Street Journal, psychiatrists are actively working to decide whether to name a new children’s disease, Disruptive Mood Dysregulation Disorder. It is thought that many children who have this disease are being misdiagnosed as being bipolar and therefore being given the wrong types of treatments. Breezy Mama spoke with Dr. Debra Kissen, a Licensed Clinical Psychologist, to find out the symptoms of Disruptive Mood Dysregulation Disorder, having your child diagnosed, the treatment and more.
What are the symptoms of Disruptive Mood Dysregulation Disorder?
The proposed diagnostic criteria for Disruptive Mood Dysregulation Disorder, if it is accepted into the DSMV is:
A. The disorder is characterized by severe recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation.
The temper outbursts are manifest verbally and/or behaviorally, such as in the form of verbal rages or physical aggression towards people or property.The temper outbursts are inconsistent with developmental level.
B. Frequency: The temper outbursts occur, on average, three or more times per week.
C. Mood between temper outbursts:
Nearly every day, most of the day, the mood between temper outbursts is persistently irritable or angry.The irritable or angry mood is observable by others (e.g., parents, teachers, peers).
D. Duration: Criteria A-C have been present for 12 or more months. Throughout that time, the person has not had 3 or more consecutive months when they were without the symptoms of Criteria A-C
When there is a child in school who often lashes out, is this an indication that they might suffer from Disruptive Mood Dysregulation Disorder?
It may be Disruptive Mood Dysregulation Disorder, but it also may be caused by an array of other conditions, such as ADHD, Anxiety, family trauma, progressive developmental delays, etc. A family should obtain a Neuropsychological evaluation, which also includes behavioral observations provided by school staff, to clarify the underlying causes of disruptive behavior at school.
What are the key differences in Disruptive Mood Dysregulation Disorder and pediatric bipolar?
The main difference is that a child does not need to be experiencing manic or hypomanic episodes in order to meet clinical criteria for Disruptive Mood Dysregulation Disorder. Instead, the child needs to be exhibiting irritability and anger.
What is the treatment for Disruptive Mood Dysregulation Disorder?
Treatment may include either medication or psychotherapy or both. The only medications approved by the FDA to treat bipolar disorder in young people are lithium (sometimes known as Eskalith), risperidone (Risperdal), and aripiprazole(Abilify).
Psychotherapy may entail CBT to help identify and improve ineffective thinking and behavioral patterns. A critical component of this treatment would entail psychoeducation on the condition, with an emphasis on the need to maintain a daily routine and a regular sleep cycle. In addition, family therapy may be useful in order to decrease negative emotions and hostility caused by navigating through this disorder.
If a parent feels their child has the symptoms, do they discuss this with their pediatrician or what steps should they take?
Yes, a good first step would be to speak with the pediatrician.
What are the chances of this being named a disease so kids aren’t misdiagnosed as bipolar?
The psychological research community is attempting to provide a more accurate set of diagnostic criteria, given that there is too much room for interpretation in attempting to use the adult diagnostic criteria for bipolar disorder, on children.
There has been a lot of articles, books, etc. on how a change in diet can drastically affect how a child behaves. Do you feel parents should modify a child’s diet before attempting medication? For example, gluten, sugar and even dairy have all been named in contributing to misbehavior and parents see a drastic change when eliminating certain foods and modifying their child’s diet. Any thoughts on this?
It can never hurt to alter a child’s diet to improve nutrition and experiment with elements that may be contributing to ineffective behaviors but I am skeptical that dietary adjustments will allow for a significant decrease in irritability and anger, to allow for maximum functioning.
About Dr. Debra Kissen, Ph.D., MHSA
Dr. Kissen is a licensed clinical psychologist and anxiety treatment specialist residing and practicing in Chicago, IL. Dr. Kissen is the Clinical Director of Light on Anxiety Treatment Center of Chicago. Light on Anxiety Treatment Center of Chicago offers CBT based treatment to children, adolescents and adults with a focus on anxiety and stress-related disorders, including obsessive-compulsive disorder, post traumatic stress disorder (PTSD), panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, specific phobias, separation anxiety disorder, compulsive skin picking, and trichotillomania.
For more information on Dr. Kissen, visit: www.lightonanxiety.com