Are youths with disruptive mood dysregulation disorder different from youths with major depressive disorder or persistent depressive disorder?

Adolescent Disruptive mood dysregulation disorder Major depressive disorder Persistent depressive disorder Retrospective chart review Suicidal behavior

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 03 2020
Historique:
received: 12 03 2019
revised: 27 11 2019
accepted: 05 01 2020
entrez: 25 2 2020
pubmed: 25 2 2020
medline: 16 2 2021
Statut: ppublish

Résumé

Although the disruptive mood dysregulation disorder (DMDD) was included in the depressive disorders (DD) section of the DSM-5, common and distinctive features between DMDD and the pre-existing DD (i.e., major depressive disorder, MDD, and persistent depressive disorder, PDD) received little scrutiny. Youths consecutively assessed as outpatients at two Canadian mood clinics over four years were included in the study (n = 163; mean age:13.4 ± 0.3; range:7-17). After controlling for inter-rater agreement, data were extracted from medical charts, using previously validated chart-review instruments. Twenty-two percent of youths were diagnosed with DMDD (compared to 36% for MDD and 25% for PDD), with substantial overlap between the three disorders. Youths with DMDD were more likely to have a comorbid non-depressive psychiatric disorder - particularly attention deficit hyperactivity disorder, odds ratio (OR=3.9), disruptive, impulse-control and conduct disorder (OR=3.0) or trauma- and stressor-related disorder (OR=2.5). Youths with DMDD did not differ with regard to the level of global functioning, but reported more school and peer-relationship difficulties compared to MDD and/or PDD. The vulnerability factors associated with mood disorders (i.e., history of parental depression and adverse life events) were found at a comparable frequency across the three groups. The retrospective design and the selection bias for mood disordered patients restricted the generalizability of the results. Youths with DMDD share several clinical features with youths with MDD and PDD. Further studies are required to determine the developmental trajectories and the benefits of expanding pharmacotherapy for DD to DMDD.

Sections du résumé

BACKGROUND
Although the disruptive mood dysregulation disorder (DMDD) was included in the depressive disorders (DD) section of the DSM-5, common and distinctive features between DMDD and the pre-existing DD (i.e., major depressive disorder, MDD, and persistent depressive disorder, PDD) received little scrutiny.
METHODS
Youths consecutively assessed as outpatients at two Canadian mood clinics over four years were included in the study (n = 163; mean age:13.4 ± 0.3; range:7-17). After controlling for inter-rater agreement, data were extracted from medical charts, using previously validated chart-review instruments.
RESULTS
Twenty-two percent of youths were diagnosed with DMDD (compared to 36% for MDD and 25% for PDD), with substantial overlap between the three disorders. Youths with DMDD were more likely to have a comorbid non-depressive psychiatric disorder - particularly attention deficit hyperactivity disorder, odds ratio (OR=3.9), disruptive, impulse-control and conduct disorder (OR=3.0) or trauma- and stressor-related disorder (OR=2.5). Youths with DMDD did not differ with regard to the level of global functioning, but reported more school and peer-relationship difficulties compared to MDD and/or PDD. The vulnerability factors associated with mood disorders (i.e., history of parental depression and adverse life events) were found at a comparable frequency across the three groups.
LIMITATIONS
The retrospective design and the selection bias for mood disordered patients restricted the generalizability of the results.
CONCLUSIONS
Youths with DMDD share several clinical features with youths with MDD and PDD. Further studies are required to determine the developmental trajectories and the benefits of expanding pharmacotherapy for DD to DMDD.

Identifiants

pubmed: 32090743
pii: S0165-0327(19)30626-3
doi: 10.1016/j.jad.2020.01.020
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

207-215

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None

Auteurs

Xavier Benarous (X)

Child and Adolescent Psychopathology Services, Amiens University Hospital, Amiens, France; INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne (UPJV), Amiens, France; Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.

Johanne Renaud (J)

Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Douglas Mental Health University Institute, McGill University, Montreal, Canada; Department of psychiatry, McGill University, Montreal, Canada.

Jean Jacques Breton (JJ)

Department of psychiatry, University of Montreal, Montreal, Canada.

David Cohen (D)

Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France; CNRS UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne Universités, UPMC, Paris, France.

Réal Labelle (R)

Department of psychiatry, University of Montreal, Montreal, Canada; Département de psychologie, Université du Québec à Montréal, Montréal, Canada; Centre de recherche, Hôpital en santé mentale Rivière-des-Prairies, CIUSSS du Nord-de-l'Île-de-Montréal, Canada; Centre for Research and Intervention on Suicide, Ethical Issues and End-of-life practices, (CRISE), Montreal, Canada.

Jean-Marc Guilé (JM)

Child and Adolescent Psychopathology Services, Amiens University Hospital, Amiens, France; INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne (UPJV), Amiens, France; Department of psychiatry, McGill University, Montreal, Canada. Electronic address: guile.jean-marc@chu-amiens.fr.

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