Disruptive Mood Dysregulation Disorder in Juvenile Justice [2018]

Disruptive mood dysregulation disorder (DMDD) is a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). We compared juvenile justice involved youths with DMDD to those with disruptive behavior disorders (DBDs) and other mood disorders, to clarify the differences and to investigate differential correlates to DMDD relative to DBDs or mood disorders. Diagnostic and demographic data were available for 9,819 youths served by 57 juvenile justice sites. A subsample of 2,498 youths had data relevant to our study. The youths self-assessed mental health status on the Voice Diagnostic Interview Schedule for Children (V-DISC), and we retrofitted the V-DISC data to derive an approximate DMDD diagnosis. The retrofitted criteria for DMDD were met by 3.3 percent of justice-involved youths. Results from multinomial regression showed that, after adjustment for covariates, those with DMDD had fewer differences compared with those with other mood disorders than did those meeting criteria for DBDs. Consistent with the DSM-5 classification of DMDD as a depressive disorder, those with DMDD shared more characteristics with youths with mood disorders than with those reporting DBDs. Externalizing behaviors leading to justice involvement may overshadow internalizing symptoms of DMDD, but mood-related conditions should be identified and treated in this population.

Megan M. Mroczkowski, Larkin S. McReynolds, Prudence Fisher and Gail A. Wasserman

Journal of the American Academy of Psychiatry and the Law, September 2018, 46 (3)