Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Am J Psychiatry. 2013 Feb;170(2):173-9. doi: 10.1176/appi.ajp.2012.12010132.
No empirical studies on the DSM-5 proposed disruptive mood dysregulation disorder have yet been published. This study estimated prevalence, comorbidity, and correlates of this proposed disorder in the community.
Prevalence rates were estimated using data from three community studies involving 7,881 observations of 3,258 participants from 2 to 17 years old. Disruptive mood dysregulation disorder was diagnosed using structured psychiatric interviews.
Three-month prevalence rates for meeting criteria for disruptive mood dysregulation disorder ranged from 0.8% to 3.3%, with the highest rate in preschoolers. Rates dropped slightly with the strict application of the exclusion criterion, but they were largely unaffected by the application of onset and duration criteria. Disruptive mood dysregulation co-occurred with all common psychiatric disorders. The highest levels of co-occurrence were with depressive disorders (odds ratios between 9.9 and 23.5) and oppositional defiant disorder (odds ratios between 52.9 and 103.0). Disruptive mood dysregulation occurred with another disorder 62%-92% of the time, and it occurred with both an emotional and a behavioral disorder 32%-68% of the time. Affected children displayed elevated rates of social impairments, school suspension, service use, and poverty.
Disruptive mood dysregulation disorder is relatively uncommon after early childhood, frequently co-occurs with other psychiatric disorders, and meets common standards for psychiatric "caseness." This disorder identifies children with severe levels of both emotional and behavioral dysregulation.
目前尚未有关于 DSM-5 中提出的破坏性心境失调障碍的实证研究。本研究旨在评估该障碍在社区中的患病率、共病率及相关因素。
使用来自三个社区研究的数据来估计患病率,这些研究共涉及 3258 名 2 至 17 岁参与者的 7881 次观察。使用结构访谈进行破坏性心境失调障碍的诊断。
符合破坏性心境失调障碍标准的 3 个月患病率为 0.8%至 3.3%,学龄前儿童患病率最高。严格应用排除标准时,患病率略有下降,但发病和持续时间标准的应用对其影响不大。破坏性心境失调与所有常见的精神障碍共病。与心境障碍(比值比为 9.9 至 23.5)和对立违抗性障碍(比值比为 52.9 至 103.0)共病的比例最高。破坏性心境失调与其他障碍共病的比例为 62%至 92%,与情绪和行为障碍共病的比例为 32%至 68%。受影响的儿童存在社交障碍、学校停学、服务利用和贫困等问题的比例较高。
破坏性心境失调障碍在幼儿期后相对少见,常与其他精神障碍共病,并符合常见的精神障碍“病例”标准。该障碍识别出存在严重情绪和行为失调的儿童。