Disruptive mood disorder: symptoms and treatment

Irritability and temper tantrums in minors are one of the most common reasons in consultations and psychological centers. Although these reactions are relatively common at these stages, their chronicity and intensity should be controlled.

When these seizures are too severe and occur too often, they can be diagnosed as a Disruptive mood disorder. Below, we talk about its symptoms and treatment, as well as the controversy surrounding this concept.

    What is disruptive mood disorder?

    Mood disruptive disorder (TDDEA) is a relatively new term in clinical psychology and psychiatry that refers to a disturbance of the child’s mood. During this time, the child has manifestations of chronic irritability and mood swings disproportionate to the situation.

    While these symptoms can also be seen in various childhood psychological disorders such as bipolar disorder, Negative Difficult Disorder (TND) or Attention Deficit Hyperactivity Disorder (ADHD), the idea of ​​creating a new concept like TDDEA was based on the goal of being able to include reprimands and cholera outbreaks in the diagnosis.

    The incorporation into the DSM-V of this new label of child behavior has been widely criticized by professionals in psychology and education, as well as by researchers in the behavioral sciences. One of these criticisms is the questioning of whether it is really necessary to create more labels for children’s behaviorAs these tend to create stigma in the child both on a personal and social level.

    On the other hand, the diagnostic criteria they do not take into account the child’s family, school or social contextThis can have a big influence on your mood and behavior, and can be the real cause of these outbursts of anger and rage.

    Finally, we wondered if this disorder was substantially different from the others already exposed. However, according to some studies, there is a disparity both in etiology and in evolution and neurobiological basis.

    Differences from pediatric bipolar disorder

    There are many cases of suspected disruptive mood disorder which, due to the similarity between the symptomatology of the two conditions, has been diagnosed as pediatric bipolar disorder.

    The main difference between the two is that, just like in bipolar disorder, the child has well-defined episodes of depressed mood and mania, with children diagnosed with TDDEA they do not experience these different episodes with such precision terminals.

    In the bipolarity of specific episodes, they mix with moments of euthymia, while in TDDEA the periods of change are much more persistent and random.

    Symptoms of TDDEA

    In order to make a satisfactory diagnosis of TDDEA without having to burden the child with unnecessary labels, the fifth volume of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes its diagnostic criteria for the disorder, including its symptoms and symptoms. exceptions. These criteria are:

    • Symptoms present in children between 6 and 18 years old of age.
    • Severe and recurrent episodes of cholera in response to common stressors. These cramps should be inconsistent with the child’s developmental level, the mood between tantrums should be irritable or irascible, and the average anger outbreak should be at least three times a week.
    • Symptoms start before the age of 10.
    • Symptoms that persist for at least 12 months.
    • symptoms they have not been missing for three consecutive months or more.
    • Symptoms should appear in at least two of the following contexts: home, school, social context; be harsh in at least one of them.
    • The symptoms cannot be better explained by any other medical condition, nor by the use of any drug or substance.
    • symptoms they do not meet the criteria for a manic or hypomanic episode for more than a day.
    • The symptoms do not meet the criteria for a major depressive episode.

    It should be noted that in no case can this diagnosis be made before the age of 6, because in these stages reprimands, outbursts and outbursts of anger are common and normative.

    On the other hand, the DSM-V specifies the impossibility of this disorder occurring at the same time as a bipolar disorder, a difficult negativistic disorder or an intermittent explosive disorder.

    Effects and consequences of TDDEA

    According to evaluations and studies in the field of child psychology, it is estimated that around 80% of children under 6 years of age express more or less recurring reproaches, becoming severe in only 20% of cases.

    So that this anger or this aggression can be considered pathological it must interfere with the child’s daily life, as well as his school performance and daily family dynamics. With regard to the family environment, this disorder tends to generate a lot of helplessness and a feeling of disorientation in the parents of the affected children, as they are unable to manage or control the behavior and actions of the child; fear of imposing penalties that are too rigid or, on the contrary, too lax.

    As for the child, the behavior is irritable it ends up affecting the latter’s relationship with his peers or peers, Who do not understand the reason for their behavior. In addition, the levels of frustration he feels are so great that his attention span ends up diminishing, hampering his academic progress.


    Due to the novelty of the concept, treatment for TDDEA is still under investigation and development by clinical professionals. However, the main intervention protocol in these cases includes the combination of drugs with psychological therapy.

    The drug of choice is usually stimulants or antidepressants, while psychotherapy consists of applied behavioral analysis. In addition, the active role of parents in the treatment is highlighted, as they will have to learn how to best manage the changes in the child’s mood.

    The pharmacological treatment of disruptive mood disorder disorder is another point where this condition has come under much criticism, calling into question the real need to care for children.

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