Disruptive Mood Dysregulation Disorder in Children

Tantrums are common in children, especially among little ones. However, sometimes, you may be dealing with an emotional and behavioral disorder. With that in mind, we want to talk about mood dysregulation disorder.
Disruptive Mood Dysregulation Disorder in Children

Last update: 05 December, 2020

Sometimes it’s difficult for parents to determine when their child’s behavior is within the evolutionary expectations and when a psychological problem exists. The presence of tantrums and behavioral problems in children is frequent, especially at early ages. However, in some cases, you may be facing a disruptive mood dysregulation disorder (DMDD).

Psychology textbooks have recently included this diagnosis. Previously, children who displayed symptoms of this syndrome received a diagnosis of pediatric bipolar disorder. However, there are important differences between the two.

Disruptive mood dysregulation disorder

Disruptive mood dysregulation disorder describes children with serious emotional and behavioral problems. The main characteristic is a constant and chronic irritable mood. In addition, disproportionate outbursts of anger and rage occur frequently (three or more times per week).

This pattern of irritability and outbursts must occur continuously for at least 12 months to be diagnosed. That is, there can’t be an interruption for a period longer than three months. In addition, the disorder must have begun before the child reaches 10 years of age.

Disruptive Mood Dysregulation Disorder in Children

A curious fact is that it’s not possible to diagnose DMDD before the age of six. This is because temper tantrums and angry outbursts are common in preschoolers and it’s not easy to pinpoint when they exceed normal intensity.

The consequences of this disorder are significant. This irritable and angry behavior is highly disruptive, so it greatly affects the child’s functioning at home or at school. In addition, there’s an increased risk of school dropouts and future problems with peer relationships.

Experts have found that this syndrome is more frequent in younger children and its presence decreases in older children and adolescents. However, DMDD is often associated with other emotional disorders (such as depression) and behavioral disorders (such as oppositional defiant disorder).

Where does DMDD come from?

As with all psychological disorders, there’s no single factor that can explain their presence. However, there are some conditions related to disruptive mood dysregulation disorder. Seventy-five percent of children who have it show a family history of mental health problems. In particular, a parental substance abuse problem may lead to the development of this disorder.

In addition, observations have revealed that parents of these children are more hostile and critical in their relationships with their children. For this reason, it’s a good idea for treatment to involve teaching other models of parenting to adults.

Child abuse and exposure of children to traumatic events are also related to DMDD. Finally, some personality traits such as outgoing temperament, impulsiveness, or reward seeking may favor the presence of this disorder.


As this is a newly established diagnosis, research is still underway to investigate the best treatment options. Certain drugs, such as stimulants or antipsychotics, have been used, with the latter producing good results. Risperidone was able to significantly reduce irritability and aggressive behavior. However, it’s important to exercise caution when administering these drugs to minors, as side effects can be severe.

With regard to psychological treatment, observations have shown that parental collaboration is of particular importance. Children with DMDD seem to be especially sensitive to changes in parenting. Therefore, training for parents, in which they learn strategies to address their child’s symptoms, has offered very good results.

Psychological work with the child will be behavioral. The objectives will be to identify the stressors and triggers that cause anger outbursts and teach the child tools to manage them properly.

It’s also advisable to have the involvement of the school and educators. They should be aware of the special needs of these children and the possible side effects of the medication, if they take it. In addition, it will be very important to show consistency, both at home and at school. This will facilitate behavior change in the child.


All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Zepf FD, Biskup CS, Holtmann M, Runions K. Trastorno de desregulación disruptiva del estado de ánimo (Matías Irarrázaval
    & Andres Martin eds. Fernanda Prieto Tagle, Irma Isasa, traducción). En Rey JM (ed), Manual de Salud Mental Infantil y Adolescente de la
    IACAPAP. Ginebra: Asociación Internacional de Psiquiatría del Niño y el Adolescente y Profesiones Afines 2017.
  • Angold A, Costello E, Egger H. Journal of Psychiatry 170(2): 173-179, Feb 2013 Prevalence, Comorbidity and Correlates of DSM-5 Proposed Disruptive Mood Dysregulation Disorder

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.