Differential Diagnosis

Bipolar disorder ,the differentiation DMDD from bipolar disorder ,the DMDD
is characterized by chronic irritability it can present over many months but in bipolar
disorder is episodic irritability[1] ,so in bipolar disorder parents should be able to
identify a distinct time period during which the child's mood and behavior were
markedly different from usual .The mood condition in DMDD usually irritability but
in bipolar disorder the mood condition are more variated euthymia, depression, and
mania.[2]
Intermittent explosive disorder ,present severe temper outbursts, much like
children with disruptive mood dysregulation disorder ,in Intermittent explosive
disorder the frequency of outbursts are 2/week for 3 months but in the DMDD the
frequency of outbursts are 3/week[1]. Intermittent explosive disorder requires only 3
months of active symptoms, in contrast to the 12-month requirement for DMDD
Oppositional defiant disorder ,both DMDD and ODD criteria include
irritability and temper outbursts. The two disorders differ in 1) severity: in DMDD,
outbursts must occur 3 times/week, but only once a week in ODD; 2) duration: 12
months for DMDD, and 6 months for ODD; and 3) pervasiveness and impairment:
DMDD must impair function in two of three settings, and be severe in one setting;
there is no such requirement for ODD[2]

1. American Psychiatric Association. Diagnostic and Statistical Manual of

Mental Disorders.; 2013
2. 1.Roy AK, Lopes V, Klein RG. Disruptive mood dysregulation disorder: A
new diagnostic approach to chronic irritability in youth. Am J Psychiatry.
2014;171(9):918-924.
3. Copeland WE, Angold A, Costello EJ, Egger H. Prevalence, comorbidity, and
correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J
Psychiatry
4. Zepf FD, Holtmann M. Disruptive mood dysregulation disorder. IACAPAP
Textb Child Adolesc Ment Heal. 2012;(110):1-11.