Department of Psychiatry and Behavioral Science, School of Medicine, State University of New York at Stony Brook, NY, USA.
Bipolar Disord. 2012 Aug;14(5):488-96. doi: 10.1111/j.1399-5618.2012.01029.x. Epub 2012 Jun 19.
The frequency of diagnosis of bipolar disorder has risen dramatically in children and adolescents. The DSM-V Work Group has suggested a new diagnosis termed disruptive mood dysregulation disorder (DMDD) (formerly temper dysregulation disorder with dysphoria) to reduce the rate of false diagnosis of bipolar disorder in young people. We sought to determine if the application of the proposed diagnostic criteria for DMDD would reduce the rate of diagnosis of bipolar disorder in children.
Eighty-two consecutively hospitalized children, ages 5 to 12 years, on a children's inpatient unit were rigorously diagnosed using admission interviews of the parents and the child, rating scales, and observation over the course of hospitalization.
Overall, 30.5% of inpatient children met criteria for DMDD by parent report, and 15.9% by inpatient unit observation. Fifty-six percent of inpatient children had parent-reported manic symptoms. Of those, 45.7% met criteria for DMDD by parent-report, though only 17.4% did when observed on the inpatient unit.
Although DMDD does decrease the rate of diagnosis of bipolar disorder in children, how much depends on whether history or observation is used.
儿童和青少年双相情感障碍的诊断频率显著上升。DSM-V 工作组提出了一种新的诊断，称为破坏性情绪失调障碍（DMDD）（以前称为伴有烦躁的情绪调节障碍），以降低年轻人中双相情感障碍误诊的比率。我们试图确定 DMDD 拟议诊断标准的应用是否会降低儿童双相情感障碍的诊断率。
82 名连续住院的儿童，年龄在 5 至 12 岁之间，在儿童住院病房进行了严格的诊断，使用入院时对父母和儿童的访谈、评分量表以及住院期间的观察。
总体而言，30.5%的住院儿童通过父母报告符合 DMDD 的标准，15.9%通过住院病房观察符合标准。56%的住院儿童有父母报告的躁狂症状。其中，45.7%的儿童通过父母报告符合 DMDD 的标准，但只有 17.4%的儿童在住院病房观察时符合标准。
尽管 DMDD 确实降低了儿童双相情感障碍的诊断率，但降低的幅度取决于使用病史还是观察结果。
