Dougherty L R, Smith V C, Bufferd S J, Carlson G A, Stringaris A, Leibenluft E, Klein D N
Department of Psychology,University of Maryland,College Park, MD,USA.
Department of Psychology,California State University San Marcos,San Marcos, CA,USA.
Psychol Med. 2014 Aug;44(11):2339-50. doi: 10.1017/S0033291713003115. Epub 2014 Jan 21.
Despite the inclusion of disruptive mood dysregulation disorder (DMDD) in DSM-5, little empirical data exist on the disorder. We estimated rates, co-morbidity, correlates and early childhood predictors of DMDD in a community sample of 6-year-olds.
DMDD was assessed in 6-year-old children (n = 462) using a parent-reported structured clinical interview. Age 6 years correlates and age 3 years predictors were drawn from six domains: demographics; child psychopathology, functioning, and temperament; parental psychopathology; and the psychosocial environment.
The 3-month prevalence rate for DMDD was 8.2% (n = 38). DMDD occurred with an emotional or behavioral disorder in 60.5% of these children. At age 6 years, concurrent bivariate analyses revealed associations between DMDD and depression, oppositional defiant disorder, the Child Behavior Checklist - Dysregulation Profile, functional impairment, poorer peer functioning, child temperament (higher surgency and negative emotional intensity and lower effortful control), and lower parental support and marital satisfaction. The age 3 years predictors of DMDD at age 6 years included child attention deficit hyperactivity disorder, oppositional defiant disorder, the Child Behavior Checklist - Dysregulation Profile, poorer peer functioning, child temperament (higher child surgency and negative emotional intensity and lower effortful control), parental lifetime substance use disorder and higher parental hostility.
A number of children met DSM-5 criteria for DMDD, and the diagnosis was associated with numerous concurrent and predictive indicators of emotional and behavioral dysregulation and poor functioning.
尽管《精神疾病诊断与统计手册》第5版（DSM-5）纳入了破坏性心境失调障碍（DMDD），但关于该障碍的实证数据很少。我们在一个6岁儿童的社区样本中估计了DMDD的发病率、共病情况、相关因素和幼儿期预测因素。
使用家长报告的结构化临床访谈对462名6岁儿童进行DMDD评估。6岁时的相关因素和3岁时的预测因素来自六个领域：人口统计学；儿童精神病理学、功能和气质；父母精神病理学；以及社会心理环境。
DMDD的3个月患病率为8.2%（n =
38）。在这些儿童中，60.5%的DMDD患者伴有情绪或行为障碍。在6岁时，双变量并发分析显示DMDD与抑郁症、对立违抗障碍、儿童行为检查表-失调剖面图、功能损害、较差的同伴功能、儿童气质（较高的外向性和负面情绪强度以及较低的努力控制能力）以及较低的父母支持和婚姻满意度之间存在关联。6岁时DMDD在3岁时的预测因素包括儿童注意力缺陷多动障碍、对立违抗障碍、儿童行为检查表-失调剖面图、较差的同伴功能、儿童气质（较高的儿童外向性和负面情绪强度以及较低的努力控制能力）、父母终身物质使用障碍以及较高的父母敌意。
许多儿童符合DMDD的DSM-5标准，并且该诊断与情绪和行为失调以及功能不良的众多并发和预测指标相关。
