Skip to main content Accessibility help
×
Home

Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder

  • Lukas Propper (a1), Jill Cumby (a2), Victoria C. Patterson (a2), Vladislav Drobinin (a2), Jacqueline M. Glover (a2), Lynn E. MacKenzie (a2), Jessica Morash-Conway (a2), Sabina Abidi (a1), Alexa Bagnell (a1), David Lovas (a1), Tomas Hajek (a3), William Gardner (a4), Kathleen Pajer (a5), Martin Alda (a3) and Rudolf Uher (a6)...

Abstract

Background

It has been suggested that offspring of parents with bipolar disorder are at increased risk for disruptive mood dysregulation disorder (DMDD), but the specificity of this association has not been established.

Aims

We examined the specificity of DMDD to family history by comparing offspring of parents with (a) bipolar disorder, (b) major depressive disorder and (c) a control group with no mood disorders.

Method

We established lifetime diagnosis of DMDD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children for DSM-5 in 180 youth aged 6–18 years, including 58 offspring of parents with bipolar disorder, 82 offspring of parents with major depressive disorder and 40 control offspring.

Results

Diagnostic criteria for DMDD were met in none of the offspring of parents with bipolar disorder, 6 of the offspring of parents with major depressive disorder and none of the control offspring. DMDD diagnosis was significantly associated with family history of major depressive disorder.

Conclusions

Our results suggest that DMDD is not specifically associated with a family history of bipolar disorder and may be associated with parental depression.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder
      Available formats
      ×

Copyright

Corresponding author

Rudolf Uher, 5909 Veterans' Memorial Drive, B3H 2E2, Halifax, Nova Scotia, Canada. Email: uher@dal.ca

Footnotes

Hide All

Declaration of interest

None.

Footnotes

References

Hide All
1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (5th edn) (DSM-5). APA, 2013.
2 Birmaher, B, Axelson, D. Course and outcome of bipolar spectrum disorder in children and adolescents: a review of the existing literature. Dev Psychopathol 2006; 18: 1023–35.
3 Leibenluft, E. Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. Am J Psychiatry 2011; 168: 129–42.
4 Roy, AK, Lopes, V, Klein, RG. Disruptive mood dysregulation disorder: a new diagnostic approach to chronic irritability in youth. Am J Psychiatry 2014; 171: 918–24.
5 Propper, L, Ortiz, A, Slaney, C, Garnham, J, Ruzickova, M, Calkin, CV, et al. Early-onset and very-early-onset bipolar disorder: distinct or similar clinical conditions? Bipolar Disord 2015; 17: 814–20.
6 Carlson, GA. Disruptive mood dysregulation disorder: where did it come from and where is it going. J Child Adolesc Psychopharmacol 2016; 26: 90–3.
7 Fristad, MA, Wolfson, H, Algorta, GP, Youngstrom, EA, Arnold, LE, Birmaher, B, et al. Disruptive mood dysregulation disorder and bipolar disorder not otherwise specified: fraternal or identical twins? J Child Adolesc Psychopharmacol 2016; 26: 138–46.
8 Mitchell, RH, Timmins, V, Collins, J, Scavone, A, Iskric, A, Goldstein, BI. Prevalence and correlates of disruptive mood dysregulation disorder among adolescents with bipolar disorder. J Child Adolesc Psychopharmacol 2016; 26: 147–53.
9 Althoff, RR, Crehan, ET, He, JP, Burstein, M, Hudziak, JJ, Merikangas, KR. Disruptive mood dysregulation disorder at ages 13–18: results from the National Comorbidity Survey – Adolescent Supplement. J Child Adolesc Psychopharmacol 2016; 26: 107–13.
10 Copeland, WE, Angold, A, Costello, EJ, Egger, H. Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J Psychiatry 2013; 170: 173–9.
11 Brotman, MA, Schmajuk, M, Rich, BA, Dickstein, DP, Guyer, AE, Costello, EJ, et al. Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biol Psychiatry 2006; 60: 991–7.
12 Stringaris, A, Cohen, P, Pine, DS, Leibenluft, E. Adult outcomes of youth irritability: a 20-year prospective community-based study. Am J Psychiatry 2009; 166: 1048–54.
13 Stringaris, A, Baroni, A, Haimm, C, Brotman, M, Lowe, CH, Myers, F, et al. Pediatric bipolar disorder versus severe mood dysregulation: risk for manic episodes on follow-up. J Am Acad Child Adolesc Psychiatry 2010; 49: 397405.
14 Copeland, WE, Shanahan, L, Egger, H, Angold, A, Costello, EJ. Adult diagnostic and functional outcomes of DSM-5 disruptive mood dysregulation disorder. Am J Psychiatry 2014; 171: 668–74.
15 Vidal-Ribas, P, Brotman, MA, Valdivieso, I, Leibenluft, E, Stringaris, A. The status of irritability in psychiatry: a conceptual and quantitative review. J Am Acad Child Adolesc Psychiatry 2016; 55: 556–70.
16 Stringaris, A, Zavos, H, Leibenluft, E, Maughan, B, Eley, TC. Adolescent irritability: phenotypic associations and genetic links with depressed mood. Am J Psychiatry 2012; 169: 4754.
17 Savage, J, Verhulst, B, Copeland, W, Althoff, RR, Lichtenstein, P, Roberson-Nay, R. A genetically informed study of the longitudinal relation between irritability and anxious/depressed symptoms. J Am Acad Child Adolesc Psychiatry 2015; 54: 377–84.
18 Krieger, FV, Polanczyk, VG, Goodman, R, Rohde, LA, Graeff-Martins, AS, Salum, G, et al. Dimensions of oppositionality in a Brazilian community sample: testing the DSM-5 proposal and etiological links. J Am Acad Child Adolesc Psychiatry 2013; 52: 389400.
19 Wiggins, JL, Mitchell, C, Stringaris, A, Leibenluft, E. Developmental trajectories of irritability and bidirectional associations with maternal depression. J Am Acad Child Adolesc Psychiatry 2014; 53: 1191–205, 1205.
20 Whelan, YM, Leibenluft, E, Stringaris, A, Barker, ED. Pathways from maternal depressive symptoms to adolescent depressive symptoms: the unique contribution of irritability symptoms. J Child Psychol Psychiatry 2015; 56: 1092–100.
21 Brotman, MA, Kassem, L, Reising, MM, Guyer, AE, Dickstein, DP, Rich, BA, et al. Parental diagnoses in youth with narrow phenotype bipolar disorder or severe mood dysregulation. Am J Psychiatry 2007; 164: 1238–41.
22 Dougherty, LR, Smith, VC, Bufferd, SJ, Stringaris, A, Leibenluft, E, Carlson, GA, et al. Preschool irritability: longitudinal associations with psychiatric disorders at age 6 and parental psychopathology. J Am Acad Child Adolesc Psychiatry 2013; 52: 1304–13.
23 Sparks, GM, Axelson, DA, Yu, H, Ha, W, Ballester, J, Diler, RS, et al. Disruptive mood dysregulation disorder and chronic irritability in youth at familial risk for bipolar disorder. J Am Acad Child Adolesc Psychiatry 2014; 53: 408–16.
24 Uher, R, Cumby, J, MacKenzie, LE, Morash-Conway, J, Glover, JM, Aylott, A, et al. A familial risk enriched cohort as a platform for testing early interventions to prevent severe mental illness. BMC Psychiatry 2014; 14: 344.
25 Endicott, J, Spitzer, RL. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry 1978; 35: 837–44.
26 First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P). Biometrics Research Department, New York State Psychiatric Institute, 2002.
27 Angst, J, Sellaro, R, Stassen, HH, Gamma, A. Diagnostic conversion from depression to bipolar disorders: results of a long-term prospective study of hospital admissions. J Affect Disord 2005; 84: 149–57.
28 Kaufman, J, Birmaher, B, Axelson, D, Perepletchikova, F, Brent, D, Ryan, N. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL 2013, DSM-5). Western Psychiatric Institute and Yale University, 2013.
29 Lin, JJ, Chang, CH, Pal, N. A revisit to contingency table and tests of independence: bootstrap is preferred to Chi-square approximations as well as Fisher's exact test. J Biopharm Stat 2015; 25: 438–58.
30 Freeman, AJ, Youngstrom, EA, Youngstrom, JK, Findling, RL. Disruptive mood dysregulation disorder in a community mental health clinic: prevalence, comorbidity and correlates. J Child Adolesc Psychopharmacol 2016; 26: 123–30.

Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder

  • Lukas Propper (a1), Jill Cumby (a2), Victoria C. Patterson (a2), Vladislav Drobinin (a2), Jacqueline M. Glover (a2), Lynn E. MacKenzie (a2), Jessica Morash-Conway (a2), Sabina Abidi (a1), Alexa Bagnell (a1), David Lovas (a1), Tomas Hajek (a3), William Gardner (a4), Kathleen Pajer (a5), Martin Alda (a3) and Rudolf Uher (a6)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder

  • Lukas Propper (a1), Jill Cumby (a2), Victoria C. Patterson (a2), Vladislav Drobinin (a2), Jacqueline M. Glover (a2), Lynn E. MacKenzie (a2), Jessica Morash-Conway (a2), Sabina Abidi (a1), Alexa Bagnell (a1), David Lovas (a1), Tomas Hajek (a3), William Gardner (a4), Kathleen Pajer (a5), Martin Alda (a3) and Rudolf Uher (a6)...
Submit a response

eLetters

Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder

Michael Fitzgerald, Psychiatrist, Trinity College Dublin
10 July 2017

Dear Editor,

I read a very important paper by Lukas Propper, called, “Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder”. I fully agree with

this paper. It is unfortunate that the American Psychiatric Association made a most serious

error with their diagnosis of Childhood Bipolar Disorder which they have now recognised.

This led to one or more millions of children being diagnosed with this condition, when they

didn’t have it and putting them at risk of being treated with lithium etc. This should have been

the end of this sorry saga, which completely mirrored the earlier phase in American Psychiatry

when schizophrenia was grossly over-diagnosed. The sad issue here is that instead of

acknowledging the mistake of Childhood Bipolar Disorder, they have tried to rescue the

situation with a non-existent condition, Disruptive Mood Dysregulation Disorder. They should

have known that when you’re in a hole, you should stop digging. Unfortunately, people rarely

do and this is another example. We have to be very grateful to the authors of this paper for

further clarifying the issue.

Reference: Propper l: Cumby J., Patterson C., Drobinin V., Glover J., MacKenzie L., Morash-Conway J., Abidi S., Bagnell A., Lovas D., Hajekt. Gardner W., Pajer K., Alda M., Uher R., “Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder”. British Journal of Psychiatry, Jun 2017, 210 (6) 408-412.
... More

Conflict of interest: None Declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *