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Disruptive Mood Dysregulation Disorder (DMDD)

DSM-5 criteria - chronic severe irritability with temper outbursts.

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1 What is the Disruptive Mood Dysregulation Disorder (DMDD)?

The Disruptive Mood Dysregulation Disorder (DMDD) is a psychosocial scoring tool used in paediatric practice. DSM-5 criteria - chronic severe irritability with temper outbursts. It scores 8 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in psychosocial
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 8 criteria: Severe recurrent temper outbursts (verbal and/or behavioural), grossly out of proportion; Outbursts inconsistent with developmental level; Outbursts occur ≥3 times per week on average; Mood between outbursts is persistently irritable/angry most of the day, nearly every day; Symptoms present ≥12 months, without a symptom-free period ≥3 months; Symptoms present in ≥2 settings (home, school, with peers) and severe in at least one; Age at diagnosis 6-18 years, with onset before age 10; No distinct period >1 day meeting full manic/hypomanic criteria. Totals are then banded: any score - Below threshold: not all required criteria are met - DMDD requires ALL of them; 8 criteria met or more - Threshold met: all criteria met - consistent with DMDD. Cannot coexist with ODD, intermittent explosive disorder or bipolar disorder (DMDD takes precedence over ODD).
  • DSM-5 threshold: 8 or more of the 8 criteria listed.
  • A diagnosis also requires clinically significant distress or impairment, the required duration, and exclusion of substance use or another condition. Screening aid only - not a diagnosis.

4 Frequently asked questions

How many criteria does the Disruptive Mood Dysregulation Disorder (DMDD) use?

8. They are Severe recurrent temper outbursts (verbal and/or behavioural), grossly out of proportion; Outbursts inconsistent with developmental level; Outbursts occur ≥3 times per week on average; Mood between outbursts is persistently irritable/angry most of the day, nearly every day; Symptoms present ≥12 months, without a symptom-free period ≥3 months; Symptoms present in ≥2 settings (home, school, with peers) and severe in at least one; and others.

What do the bands of the Disruptive Mood Dysregulation Disorder (DMDD) mean?

The total is interpreted as: any score - Below threshold: not all required criteria are met - DMDD requires ALL of them; 8 criteria met or more - Threshold met: all criteria met - consistent with DMDD. Cannot coexist with ODD, intermittent explosive disorder or bipolar disorder (DMDD takes precedence over ODD).

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

DSM-5 threshold: 8 or more of the 8 criteria listed.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

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For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.