Disruptive mood dysregulation disorder in adults: A case report

Abstract

Introduction

Disruptive mood dysregulation disorder (DMDD) defined by DSM-V is characterized by severe and recurrent temper outbursts and persistently irritable or angry mood.

Objectives

Our aim is to attract attention to an adult case with DMDD since the literature is lacking adult manifestations.

Case report

A 18-year-old boy have been on follow-up in our outpatient clinic since he was 12 with complaints of being increasingly irritable and angry during most of the day. He had temper tantrums six or seven times per week involving verbal rages, physical aggression and throwing things to friends and family members. There had never been a distinct period lasting more than one day during which the full symptom criteria, for a manic, hypomanic or a depressive episode had been met. He was also reported to be hyperactive, impulsive, and had difficulty concentrating and focusing since he was seven. Laboratory evaluations were within normal limits. Results of screening forms provided by parents and teachers supported the presence of attention deficit and hyperactivity disorder (ADHD). ASRS, YMRS, STAXI, SCID-I, Diagnostic Interview for Adult ADHD (DIVA) were the psychometric evaluations carried out in order better to characterize the clinical situation.

Results

He was considered as fulfilling DSM-5 criteria for ADHD and DMDD, and started on sertraline 50 mg/day and OROS methylphenidate 36 mg/day. At the following visits, temper tantrums were much reduced and there were moderate improvement in ADHD symptoms.

Conclusions

By defining the adult manifestations of DMDD accurately, clinicians will be able to improve diagnosis and care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.