If you are like me, I am sure that you are tired of people calling every young man or young woman with a series of temper outbursts automatically Bipolar Disorder. Well, the DSM-5 Task Force has decided to take a closer look at the constellation of several symptoms that may look like this disorder, but are actually not the dreaded disorder of Bipolar Illness. Now don’t get me wrong, we certainly have novel and great treatment paradigms for Bipolar but the stigma of the possibility of having a mental illness, especially Bipolar or Schizophrenia, may run some people away from seeking out the help of a psychiatrists for their child.
The new disorder found in DSM-5 is called “Disruptive Mood Dysregulation Disorder.” (296.99/F24.8) After reading the newly released diagnostic criteria, I can certainly appreciate the work that my colleagues have done to bring light to a set of behaviors that we see in young men and women before the age of 18. It is also important to note that this diagnosis should not be documented initially before the age of 6 years old. There are certainly other considerations but not this diagnosis is particular. The team also noted that the diagnosis, should not be something new after the age of 18 years old. After 18, I personally would start looking at one of the other mood disorders.
I really like what I am seeing in out new manuel. It is seemingly going to require more expertise and reading from those that use it regularly. We can no longer just tag diagnostic criteria on a child without the appropriate work-up and clinical data from collateral sources.
Disruptive Mood Dysregulation Disorder Diagnostic Criteria (Taken from DSM-5; Copyright the American Psychiatric Association 2013)
A. Severe recurrrent temper outbursts manifested verbally and or behaviorally that are grossly out of proportion in intensity to the situation or provocation.
B. The temper outbursts are inconsistent with developmental level.
C. The temper outburst occur, on average, 3 or more times a week.
D. The mood between outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by parents, teachers and peers.
E. Criteria A have been present for 12 or more months. Throughout that time, the individual has not had a period lasting 3 or more consecutive months without all of the symptoms.
F. Criteria A and D are present in a t least 2 of 3 settings and are severe in a least one of these.
G. The diagnosis should not be made for the first time before age 6 years or after the age of 18 years.
H. By history or observation, the age at onset of Criteria A-E is before 10 years.
I. There has never been a distinct period lasting more that 1 day during which the full symptom criteria, except duration, for a manic or hypomanic episode have been met.
J. The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder.
K. The symptoms are not caused by the physiological effects of a substance or caused by another medical or neurological condition.
Now fell free to peruse the blog for DSM-IV diagnostic criteria for Bipolar Illness. However, be reminded that DSM-5 is new and there will certainly be more articles to come updating you on any changes, deletions or additions to our current classification system.
Once again stay tuned and hang-out on the blog and check at some more articles, including the latest update on the Diagnosis ADHD in Adults.
Thanks for stopping by,
*Please be advised that only a licensed Provider can diagnose brain diseases in America.