Disruptive Mood Dysregulation Disorder at Age Six and Clinical and Functional Outcomes Three Years Later

Abstract

Background

Little is known about the predictive validity of disruptive mood dysregulation disorder (DMDD). This longitudinal, community-based study examined associations of DMDD at age six with psychiatric disorders, functional impairment, peer functioning, and service use at age nine.

Methods

473 children were assessed at ages six and nine. Child psychopathology and functional impairment were assessed at age six with the Preschool Age Psychiatric Assessment (PAPA) with parents and at age nine with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) with parents and children. At age nine, mothers, fathers and youth completed the Child Depression Inventory (CDI) and the Screen for Anxiety Related Disorders (SCARED), and teachers and K-SADS interviewers completed measures of peer functioning. Significant demographic covariates were included in all models.

Results

DMDD at age six predicted a current diagnosis of DMDD at age nine. DMDD at age six also predicted current and lifetime depressive disorder and attention-deficit/hyperactivity disorder (ADHD) at age nine, after controlling for all age six psychiatric disorders. In addition, DMDD predicted depressive, ADHD, and disruptive behavior disorder (DBD) symptoms on the K-SADS, and maternal and paternal reports of depressive symptoms on the CDI, after controlling for the corresponding symptom scale at age six. Lastly, DMDD at age six predicted greater functional impairment, peer problems, and educational support service use at age nine, after controlling for all psychiatric disorders at age six.

Conclusions

Children with DMDD are at high risk for impaired functioning across childhood, and this risk is not accounted by comorbid conditions.