Who Are Children with DMDD?: Clinical and Therapeutic Issues in Disruptive Mood Dysregulation Disorder

Over the past two decades, the number of children and adolescents diagnosed and treated for bipolar disorder has increased significantly, even though only a few of them actually met the criteria for "typical" bipolar disorder. The controversy centered on young patients with chronic irritability, severe and recurrent temper tantrums, and a high rate of comorbidity with ADHD-patients who, until recently, were considered to be suffering from a developmental form of mania. A new diagnosis, still evolving, appeared in the DSM-5 in 2013: DMDD (Disruptive Mood Dysregulation Disorder), a condition that differs substantially from bipolar disorder in clinical, therapeutic, and prognostic terms. In this manuscript, we will explore the clinical challenges, comorbidities, and therapeutic perspectives for this new diagnosis in child and adolescent psychiatry.