Predisposing Variables in Children with Risk of Disruptive Mood: A Clinical Case–Control Study

ABSTRACT

Disruptive mood dysregulation disorder (DMDD) is defined in the DSM-V as frequent, severe temper outbursts that significantly impair functioning in different environments. This was a second-stage of follow-up study, conducted to screen the frequency of DMDD in an elementary school. In the first-stage of our study, 453 children between ages 7–11 were evaluated in terms of DMDD high-risk with Children Behavior Check List (CBCL). Of the children, 30 high-risk and 30 low-risk children for DMDD according to CBCL agreed to participate this clinical case–control study. Diagnoses of anxiety disorder, attention deficit and hyperactivity disorder (ADHD), and oppositional defiant disorder were more common among children in the high-risk group than the control group. Symptom Checklist-90-Revised (SCL-90-R) mothers’ interpersonal, anger, and paranoid subscale scores were higher in the DMDD high-risk group than the control group. Children in the DMDD high-risk group scored higher than the control group in all SRS subscales. In the Diagnostic Analysis of Nonverbal Accuracy (DANVA) test, the DMDD high-risk group had higher error rates for fearful and intense facial expressions. Multiple linear regression analysis showed that having a diagnosis of ADHD, high maternal SCL-90-R anger score, and presence of a paternal psychiatric diagnosis increased the high-risk of DMDD.

Acknowledgements

The authors thank all the children and their families whose participation made this study possible.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical considerations

All the participants, both patients and caregivers, gave written informed consent before the inclusion and all the ethical procedures were performed. The study protocol was approved by the Marmara University School of Medicine Ethics Committee (09.2020.975).

Author contributions

Concept – M.G., L.E.T., A.B.E.Y.; Design – M.G., L.E.T.; Supervision – A.B.E.Y.; Materials – M.G., L.E.T., A.B.E.Y.; Data Collection and/or Processing – M.G., L.E.T.; Analysis and/or Interpretation – M.G., A.B.E.Y.; Literature Review – M.G., L.E.T.; Writing – M.G., A.B.E.Y.; Critical Review – A.B.E.Y.

Additional information

Funding

There was no funding for this work.

Notes on contributors

Muhsine Göksu

Muhsine Göksu is a child and adolescent psychiatrist at Marmara University Training and Research Hospital. She has specialized in mood disorders and child abuse.

Ayșe Burcu Erdoğdu Yıldırım

Ayșe Burcu Erdoğdu Yıldırım is a child and adolescent psychiatry professor at Marmara University Faculty of Medicine. Her research has focused on psychopathologies and sexual dissatisfaction in children and adolescents.

Leyla Ezgi Tüğen

Leyla Ezgi Tüğen is a child and adolescent psychiatrist in a private office. Her research areas are neurodevelopmental disorders.