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      Perinatal and postnatal risk factors for disruptive mood dysregulation disorder at age 11: 2004 Pelotas Birth Cohort Study

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          Abstract

          Background

          To date, there have been few studies of DMDD examining the risk factors during gestation and during the first years of life. We assessed the perinatal and postnatal risk factors associated with the occurrence of disruptive mood dysregulation disorder (DMDD) by 11 years of age.

          Methods

          Prospective longitudinal study. Mothers completed a standardized questionnaire shortly after childbirth. We used the Development and Well-Being Assessment, administered to the mothers or legal guardians, to identify DMDD among the 11-year-old subjects. We also employed logistic regression to perform bivariate and multivariate analyses, using a theoretical model of conceptual analysis.

          Results

          We evaluated data related to 3563 subjects at 11 years of age. The prevalence of DMDD was 2.5% (95% CI=2.0–3.0). After adjusting for potential confounders, we found that the early risk factors for the development of DMDD by 11 years of age were maternal mood symptoms during pregnancy, maternal depression during the first years after childbirth, and low maternal level of education.

          Limitations

          We were unable to evaluate the genetic characteristics of the family at the birth of each subject, and there were no data available regarding the prenatal or postnatal mental health of the fathers.

          Conclusions

          The prevalence of DMDD in early adolescence is low and its risk factors are related to potentially modifiable maternal characteristics. Scientific evidence indicates that DMDD is a major predictor of other psychiatric disorders, especially depression and anxiety. Effective prenatal and postnatal mental health care could prevent mental disorders in offspring.

          Highlights

          • •

            DMDD is characterized by irritability and persistent outbursts of anger.

          • •

            DMDD is a new diagnosis included in DSM-5.

          • •

            The prevalence of DMDD in early adolescence is low.

          • •

            DMDD risk factors are related to potentially modifiable maternal characteristics.

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          Most cited references17

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          The role of conceptual frameworks in epidemiological analysis: a hierarchical approach.

          C Victora, S Huttly, Charles S. Fuchs … (1997)
          This paper discusses appropriate strategies for multivariate data analysis in epidemiological studies. In studies where determinants of disease are sought, it is suggested that the complex hierarchical inter-relationships between these determinants are best managed through the use of conceptual frameworks. Failure to take these aspects into consideration is common in the epidemiological literature and leads to underestimation of the effects of distal determinants. An example of this analytical approach, which is not based purely on statistical associations, is given for assessing determinants of mortality due to diarrhoea in children. Conceptual frameworks provide guidance for the use of multivariate techniques and aid the interpretation of their results in the light of social and biological knowledge.
          Article 0 comments Cited 246 times – based on 0 reviews     Review now
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            Fetal growth and perinatal viability in California.

            G Cunningham, John W. Hawes, Adrian Williams … (1982)
            To produce more appropriate information for evaluating fetal growth and viability, vital records data were used to compute percentile curves and perinatal, neonatal, and fetal mortality rates at specific birth weights and gestational ages. Percentile values were in good agreement with previous studies, and the large number of births (2,288,806) allowed for a more precise determination of fetal viability at various weight-age combinations than has been previously available. Mortality rates were found to be much more sensitive to birth weight than to gestational age, especially for small-for-gestational age fetuses. Optimal weight-age combinations were found to be up to 500 g and 2 weeks greater than the average combination. The results consistently emphasize the importance of rapid and sustained fetal growth at all gestational ages.
            Article 0 comments Cited 128 times – based on 0 reviews     Review now
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              The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review

              Pablo Vidal-Ribas, Melissa A Brotman, María del Val Valdivieso … (2016)
              Objective Research and clinical interest in irritability have been on the rise in recent years. Yet several questions remain about the status of irritability in psychiatry, including whether irritability can be differentiated from other symptoms, whether it forms a distinct disorder, and whether it is a meaningful predictor of clinical outcomes. In this article, we try to answer these questions by reviewing the evidence on how reliably irritability can be measured and its validity. Method We combine a narrative and systematic review and meta-analysis of studies. For the systematic review and meta-analysis, we searched studies in PubMed and Web of Science based on preselected criteria. A total of 163 articles were reviewed, and 24 were included. Results We found that irritability forms a distinct dimension with substantial stability across time, and that it is specifically associated with depression and anxiety in longitudinal studies. Evidence from genetic studies reveals that irritability is moderately heritable, and its overlap with depression is explained mainly by genetic factors. Behavioral and neuroimaging studies show that youth with persistent irritability exhibit altered activations in the amygdala, striatum, and frontal regions compared with age-matched healthy volunteers. Most knowledge about the treatment of irritability is based on effects of treatment on related conditions or post hoc analyses of trial data. Conclusion We identify a number of research priorities including innovative experimental designs and priorities for treatment studies, and conclude with recommendations for the assessment of irritability for researchers and clinicians.
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                Author and article information

                Contributors
                Tiago N. Munhoz
                Journal
                Journal ID (nlm-ta): J Affect Disord
                Journal ID (iso-abbrev): J Affect Disord
                Title: Journal of Affective Disorders
                Publisher: Elsevier/North-Holland Biomedical Press
                ISSN (Print): 0165-0327
                ISSN (Electronic): 1573-2517
                Publication date PMC-release: 1 June 2017
                Publication date (Print): June 2017
                Volume: 215
                Pages: 263-268
                Affiliations
                [a ]Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
                [b ]Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
                [c ]Health and Behavior Postgraduate Program, Catholic University of Pelotas, Pelotas, RS, Brazil
                [d ]Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
                Author notes
                [* ]Correspondence to: Centro de Pesquisas Epidemiológicas - Universidade Federal de Pelotas, Rua Marechal Deodoro, CEP: 96020-220- Caixa Postal 464, 1160 Pelotas, RS, Brasil. tyagomunhoz@ 123456hotmail.com
                Article
                Publisher ID: S0165-0327(16)31888-2
                DOI: 10.1016/j.jad.2017.03.040
                PMC ID: 5408904
                PubMed ID: 28347949
                SO-VID: 8b879e7a-d796-4105-b36a-dda2d29461e7
                Copyright © © 2017 The Authors
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 12 October 2016
                Date revision received : 21 December 2016
                Date accepted : 11 March 2017
                Categories
                Subject: Research Paper

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: adolescent psychiatry,mood disorders,neurodevelopmental disorders,mental disorders diagnosed in childhood,epidemiology,mental disorders
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: adolescent psychiatry, mood disorders, neurodevelopmental disorders, mental disorders diagnosed in childhood, epidemiology, mental disorders

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