Baweja Raman, Mayes Susan D, Hameed Usman, Waxmonsky James G
Department of Psychiatry, Penn State University College of Medicine, Hershey, PA, USA.
Neuropsychiatr Dis Treat. 2016 Aug 24;12:2115-24. doi: 10.2147/NDT.S100312. eCollection 2016.
Disruptive mood dysregulation disorder (DMDD) was introduced as a new diagnostic entity under the category of depressive disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It was included in DSM-5 primarily to address concerns about the misdiagnosis and consequent overtreatment of bipolar disorder in children and adolescents. DMDD does provide a home for a large percentage of referred children with severe persistent irritability that did not fit well into any DSM, Fourth Edition (DSM-IV) diagnostic category. However, it has been a controversial addition to the DSM-5 due to lack of published validity studies, leading to questions about its validity as a distinct disorder. In this article, the authors discuss the diagnostic criteria, assessment, epidemiology, criticism of the diagnosis, and pathophysiology, as well as treatment and future directions for DMDD. They also review the literature on severe mood dysregulation, as described by the National Institute of Mental Health, as the scientific support for DMDD is based primarily on studies of severe mood dysregulation.
破坏性心境失调障碍（DMDD）在《精神疾病诊断与统计手册》第五版（DSM-5）中作为抑郁障碍类别下的一种新诊断实体被引入。它被纳入DSM-5主要是为了解决对儿童和青少年双相情感障碍误诊及随之而来的过度治疗的担忧。DMDD确实为很大一部分被转诊的、有严重持续性易激惹症状但不符合《精神疾病诊断与统计手册》第四版（DSM-IV）任何诊断类别的儿童提供了归属。然而，由于缺乏已发表的效度研究，它在DSM-5中的加入一直存在争议，这引发了对其作为一种独特障碍的效度的质疑。在本文中，作者讨论了DMDD的诊断标准、评估、流行病学、对该诊断的批评、病理生理学，以及治疗方法和未来方向。他们还回顾了美国国立精神卫生研究所所描述的关于严重情绪失调的文献，因为对DMDD的科学支持主要基于对严重情绪失调的研究。
