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Disruptive Mood Dysregulation Disorder

Francisco R de la Peña, Marcos F Rosetti, Andrés Rodríguez-Delgado, Lino R Villavicencio, Juan D Palacio, Cecilia Montiel, Pablo A Mayer, Fernando J Félix, Marcela Larraguibel, Laura Viola, Silvia Ortiz, Sofía Fernández, Aurora Jaímes, Miriam Feria, Liz Sosa, Lino Palacios-Cruz, Rosa E Ulloa
Changes to the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) incorporate the inclusion or modification of six disorders: Autism Spectrum Disorder, Social Anxiety Disorder, Intermittent Explosive Disorder, Disruptive Mood Dysregulation Disorder, Avoidant/Restrictive Food Intake Disorder and Binge Eating Disorder. The objectives of this study were to assess the construct validity and parent-child agreement of these six disorders in the Spanish language Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL-5) in a clinical population of children and adolescents from Latin America...
March 1, 2018: Journal of Psychiatric Research
Jillian Lee Wiggins, Margaret J Briggs-Gowan, Ryne Estabrook, Melissa A Brotman, Daniel S Pine, Ellen Leibenluft, Lauren S Wakschlag
OBJECTIVE: Advances in developmentally sensitive measurement have enabled differentiation of normative versus clinically salient irritability in early childhood. However, clinical application of these measures is still nascent. The authors developed an optimized model of clinically salient irritable behaviors at preschool age. Based on this model, the authors derived an empirically based cutoff in relation to concurrent DSM-5 irritability-related disorders (i.e., oppositional defiant disorder, disruptive mood dysregulation disorder, other depressive disorders) and used longitudinal models to test the predictive validity of the cutoff for impairment and irritability trajectories and later DSM disorders...
March 2018: Journal of the American Academy of Child and Adolescent Psychiatry
R J R Blair
Empathy and anger are two social emotions that modulate an individual's risk for aggression. Empathy is an emotional reaction to another individual's emotional state. Anger is an emotional reaction to threat, frustration or social provocation. Reduced empathy, seen in psychopathy, increases the risk for goal-directed aggression. Atypically increased anger (i.e. irritability), seen in conditions like disruptive mood dysregulation disorder and borderline personality disorder, increases the risk for reactive aggression...
April 19, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
Kazuyoshi Ogasawara, Yukako Nakamura, Hiroyuki Kimura, Branko Aleksic, Norio Ozaki
The authors present a narrative review from the diagnostic and nosologic viewpoints of mood disorders (bipolar and depressive ones) by revisiting the revision from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision to DSM-5, including the following: the separation of the bipolar and depressive sections; the addition of increased energy and continuation of symptoms to the hypo/manic criteria; the elimination of mixed episodes; the creation of new categories and specifiers ("other specified bipolar and related disorder", "disruptive mood dysregulation disorder", "with anxious distress", "with mixed features", "with peripartum onset"); the categorization of hypo/manic episodes during antidepressant treatment into bipolar disorder; the elimination of the "bereavement exclusion"; the ambiguous separation between bipolar I and II; the insufficient distinction between "other specified bipolar and related disorders" and major depressive disorder; the differentiation regarding borderline personality disorder; agitation; premenstrual dysphoric disorder; and society and psychiatry...
February 2018: Journal of Neural Transmission
Argyris Stringaris, Pablo Vidal-Ribas, Melissa A Brotman, Ellen Leibenluft
BACKGROUND: Irritability is one of the most common reasons for referral to child and adolescent mental health services and is the main characteristic of the new diagnosis of disruptive mood dysregulation disorder (DMDD). However, the recognition and management of irritability presents a major challenge in clinical practice and may be partly responsible for the dramatic increase in antipsychotic prescribing in recent years. METHODS: In this review, we provide up-to-date information on the definition and mechanisms underlying irritability, and its assessment in clinical practice...
October 30, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Megan E Tudor, Karim Ibrahim, Emilie Bertschinger, Justyna Piasecka, Denis G Sukhodolsky
Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnosis in the field of childhood onset disorders. Characterized by both behavior and mood disruption, DMDD is a purportedly unique clinical presentation with few relevant treatment studies to date. The current case study presents the application of cognitive-behavioral therapy (CBT) for anger and aggression in a 9-year-old girl with DMDD, co-occurring attention deficit hyperactivity disorder (ADHD), and a history of unspecified anxiety disorder...
December 2016: Clinical Case Studies
Katharina Grau, Paul L Plener, Sarah Hohmann, Jörg M Fegert, Elmar Brähler, Joana Straub
OBJECTIVE: According to DSM-5, Disruptive Mood Dysregulation Disorder (DMDD) is characterized by chronic temper outbursts and irritable moods. So far, little is known about its prevalence rate, course and influence on individual well-being. We assessed the prevalence rates of DMDD symptoms during adulthood and primary school age - the latter retrospectively - and studied their relationship with psychiatric disorders and socioeconomic variables. METHODS: A total of 2,413 subjects, aged 18-94 years, participated in this population-based, representative study based on self-reports...
October 25, 2017: Zeitschrift Für Kinder- und Jugendpsychiatrie und Psychotherapie
Stephen M James, Kimberly A Honn, Shobhan Gaddameedhi, Hans P A Van Dongen
PURPOSE OF REVIEW: Our 24/7 society is dependent on shift work, despite mounting evidence for negative health outcomes from sleep displacement due to shift work. This paper reviews short- and long-term health consequences of sleep displacement and circadian misalignment due to shift work. RECENT FINDINGS: We focus on four broad health domains: metabolic health; risk of cancer; cardiovascular health; and mental health. Circadian misalignment affects these domains by inducing sleep deficiency, sympathovagal and hormonal imbalance, inflammation, impaired glucose metabolism, and dysregulated cell cycles...
June 2017: Current Sleep Medicine Reports
Madeline L Pfau, Caroline Ménard, Scott J Russo
Mood disorders such as depression are among the most prevalent psychiatric disorders in the United States, but they are inadequately treated in a substantial proportion of patients. Accordingly, neuropsychiatric research has pivoted from investigation of monoaminergic mechanisms to exploration of novel mediators, including the role of inflammatory processes. Subsets of mood disorder patients exhibit immune-related abnormalities, including elevated levels of proinflammatory cytokines, monocytes, and neutrophils in the peripheral circulation; dysregulation of neuroglia and blood-brain barrier function; and disruption of gut microbiota...
January 6, 2018: Annual Review of Pharmacology and Toxicology
Francheska Perepletchikova, Donald Nathanson, Seth R Axelrod, Caitlin Merrill, Amy Walker, Meredith Grossman, James Rebeta, Lawrence Scahill, Joan Kaufman, Barbara Flye, Elizabeth Mauer, John Walkup
OBJECTIVE: Persistent irritability and behavior outbursts in disruptive mood dysregulation disorder (DMDD) are associated with severe impairment in childhood and with negative adolescent and adult outcomes. There are no empirically established treatments for DMDD. This study examined the feasibility and preliminary efficacy of dialectical behavior therapy adapted for preadolescent children (DBT-C) with DMDD. METHOD: Children 7 to 12 years old with DMDD (N = 43) were randomly assigned 1:1 to DBT-C or treatment as usual (TAU)...
October 2017: Journal of the American Academy of Child and Adolescent Psychiatry
James G Waxmonsky, Susan D Mayes, Susan L Calhoun, Julio Fernandez-Mendoza, Daniel A Waschbusch, Brianna H Bendixsen, Edward O Bixler
BACKGROUND: Many youth experience persistent irritability and recurrent temper outbursts, conceptualized by DSM-5 as Disruptive Mood Dysregulation Disorder (DMDD). Sleep deprivation impairs emotion regulation which could increase rates of DMDD symptoms, especially in those with preexisting regulatory impairments, as seen with ADHD. However, there has been little examination of the relationship between chronic sleep problems and DMDD symptoms. METHODS: Associations between DMDD symptoms and sleep parameters in children were assessed using parent-report and objective measures of sleep in a general population sample (N = 665) and an ADHD sample (N = 784)...
September 2017: Sleep Medicine
Katie J S Lewis, Arianna Di Florio, Liz Forty, Katherine Gordon-Smith, Amy Perry, Nick Craddock, Lisa Jones, Ian Jones
BACKGROUND: Women with bipolar disorder are at high risk of affective psychoses following childbirth (i.e. "postpartum psychosis", PP) and there is a need to identify which factors underlie this increased risk. Vulnerability to mood dysregulation following sleep loss may influence risk of PP, as childbirth is typified by sleep disruption. We investigated whether a history of mood episodes triggered by sleep loss was associated with PP in women with bipolar disorder (BD). METHODS: Participants were 870 parous women with BD recruited to the Bipolar Disorder Research Network...
January 1, 2018: Journal of Affective Disorders
Ebrahim Haroon, Andrew H Miller
Neuroprogression is a term used to describe worsening psychopathology, poor treatment response, and declining cognitive and functional outcomes among patients with chronic mental disorders. Chronic inflammatory activation and glutamate-mediated excitotoxicity are two key etiological factors implicated in the development of neuroprogression. In this chapter, we hypothesize that the association between chronic inflammatory activation, neuroprogression, and glutamate dysregulation might be mediated by glial dysfunction...
2017: Modern Trends in Pharmacopsychiatry
Cecilia J Hillard
The goal of this review is to summarize studies in which concentrations of circulating endocannabinoids in humans have been examined in relationship to physiological measurements and pathological status. The roles of endocannabinoids in the regulation of energy intake and storage have been well studied and the data obtained consistently support the hypothesis that endocannabinoid signaling is associated with increased consumption and storage of energy. Physical exercise mobilizes endocannabinoids, which could contribute to refilling of energy stores and also to the analgesic and mood-elevating effects of exercise...
January 2018: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Jun Chen, Zuowei Wang, Yiru Fang
Disruptive mood dysregulation disorder was newly included as a diagnostic category in Diagnostic and statistical manual of mental disorders fifth edition (DSM-5), but the knowledge about it in the clinical practice field is still limited. Therefore, the aim of the present article is to introduce this diagnostic category's history, key points of diagnosis, treatment and its impact on clinical practice for clinical reference.
October 25, 2016: Shanghai Archives of Psychiatry
Anindit Chhibber, Sarah K Woody, M A Karim Rumi, Michael J Soares, Liqin Zhao
Depression currently affects 350 million people worldwide and 19 million Americans each year. Women are 2.5 times more likely to experience major depression than men, with some women appearing to be at a heightened risk during the menopausal transition. Estrogen signaling has been implicated in the pathophysiology of mood disorders including depression; however, the underlying mechanisms are poorly understood. In this study, the role of estrogen receptor (ER) subtypes, ERα and ERβ, in the regulation of brain-derived neurotrophic factor (BDNF) and serotonin (5-HT) signaling was investigated; two pathways that have been hypothesized to be interrelated in the etiology of depression...
August 2017: Psychoneuroendocrinology
Melissa A Brotman, Katharina Kircanski, Ellen Leibenluft
Irritability is a common and impairing clinical presentation in children and adolescents. Despite its significant public health impact, irritability remains an elusive construct. Chronic and severe irritability is the primary symptom of the new DSM-5 diagnosis, disruptive mood dysregulation disorder (DMDD). However, empirical and clinical approaches to irritability are in their relative infancy, and questions regarding the validity of the DMDD diagnosis have been raised. Moreover, irritability is a trait distributed continuously in youth, thereby fitting within the National Institute of Mental Health Research Domain Criteria initiative...
May 8, 2017: Annual Review of Clinical Psychology
David Pagliaccio, Jillian Lee Wiggins, Nancy E Adleman, Alexa Curhan, Susan Zhang, Kenneth E Towbin, Melissa A Brotman, Daniel S Pine, Ellen Leibenluft
OBJECTIVE: Disruptive mood dysregulation disorder (DMDD), characterized by severe irritability, and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid. This is the first study to characterize neural and behavioral similarities and differences in attentional functioning across these disorders. METHOD: Twenty-seven healthy volunteers, 31 patients with DMDD, and 25 patients with ADHD (8 to 18 years old) completed a functional magnetic resonance imaging attention task...
May 2017: Journal of the American Academy of Child and Adolescent Psychiatry
Lea R Dougherty, Chelsey S Barrios, Gabrielle A Carlson, Daniel N Klein
OBJECTIVE: This study aimed to identify childhood factors that predict later psychiatric problems in children with disruptive mood dysregulation disorder (DMDD). METHODS: The sample consisted of 36 6-year-old children who met criteria for DMDD who were followed up at 9 years of age. Child psychopathology was assessed at age 6 using the Preschool Age Psychiatric Assessment (PAPA) and at age 9 using the Kiddie-Schedule for Affective Disorders and Schizophrenia. We compared children with DMDD at age 6 who continued to have a psychiatric diagnosis at age 9 (n = 17) to children with DMDD at age 6 with no psychiatric diagnosis at age 9 (n = 19) across several age 6 predictors: child psychopathology, irritability and temperament, parenting, and maternal psychopathology...
June 2017: Journal of Child and Adolescent Psychopharmacology
Lukas Propper, Jill Cumby, Victoria C Patterson, Vladislav Drobinin, Jacqueline M Glover, Lynn E MacKenzie, Jessica Morash-Conway, Sabina Abidi, Alexa Bagnell, David Lovas, Tomas Hajek, William Gardner, Kathleen Pajer, Martin Alda, Rudolf Uher
BackgroundIt has been suggested that offspring of parents with bipolar disorder are at increased risk for disruptive mood dysregulation disorder (DMDD), but the specificity of this association has not been established.AimsWe examined the specificity of DMDD to family history by comparing offspring of parents with (a) bipolar disorder, (b) major depressive disorder and (c) a control group with no mood disorders.MethodWe established lifetime diagnosis of DMDD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children for DSM-5 in 180 youth aged 6-18 years, including 58 offspring of parents with bipolar disorder, 82 offspring of parents with major depressive disorder and 40 control offspring...
June 2017: British Journal of Psychiatry: the Journal of Mental Science
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