Predictors of Later Psychopathology in Young Children with Disruptive Mood Dysregulation Disorder.

objectiveThis study aimed to identify childhood factors that predict later psychiatric problems in children with disruptive mood dysregulation disorder (DMDD).

methodsThe sample consisted of 36 6-year-old children who met criteria for DMDD who were followed up at 9 years of age. Child psychopathology was assessed at age 6 using the Preschool Age Psychiatric Assessment (PAPA) and at age 9 using the Kiddie-Schedule for Affective Disorders and Schizophrenia. We compared children with DMDD at age 6 who continued to have a psychiatric diagnosis at age 9 (n = 17) to children with DMDD at age 6 with no psychiatric diagnosis at age 9 (n = 19) across several age 6 predictors: child psychopathology, irritability and temperament, parenting, and maternal psychopathology. In addition, we examined whether children with DMDD at age 6 and no psychiatric diagnosis at age 9 continued to experience elevated psychiatric symptoms and impairment at age 9 compared to children with a non-DMDD diagnosis at age 6 and no psychiatric diagnosis at age 9 (n = 44) and children with no psychiatric diagnosis at age 6 or 9 (n = 266).

resultsThe following variables predicted which children with DMDD at age 6 would have a psychiatric diagnosis at age 9: higher levels of externalizing symptoms, anger/frustration, headstrong/hurtful behaviors, functional impairment, and temperamental surgency and negative affect; lower levels of effortful control/executive functioning; and maternal depression. However, children with DMDD at age 6 and no psychiatric diagnosis at age 9 continued to demonstrate greater disruptive behavior disorder symptoms and impairment at age 9 compared to children with no psychiatric diagnosis at age 6 or 9.

conclusionsThese findings identify factors predicting later psychopathology in children with DMDD. In addition, we found that the subgroup of children with DMDD at age 6 but no psychiatric diagnosis at age 9 continued to evidence symptomatology and impairment 3 years later.