Emotional and cognitive conflict resolution and disruptive mood dysregulation disorder in adolescent offspring of parents diagnosed with major depressive disorder, bipolar disorder, and matched healthy controls.

AIMS: Children of parents with mood disorders have an elevated risk for various psychopathologies. In this study rate of psychopathologies among adolescent offspring of parents with major depressive (MDDoff) and bipolar disorder (BDoff), including disruptive mood dysregulation disorder (DMDD) along with the offspring ability to resolve cognitive and emotional conflicts were evaluated. METHOD: 12-16 years old children of parents with MDD (n = 31, children= 36), BP (n = 20, children = 26) and controls (n = 25, children = 28) were enrolled. Children and parents were evaluated by using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID); respectively. The parents completed the Child Behavior Checklist (CBCL)-dysregulation profile. The Stroop test-TBAG form and emotional Stroop test were given out to evaluate conflict resolution ability. RESULTS: The most common diagnoses among the whole sample were attention deficit and hyperactivity, separation anxiety and oppositional defiant disorders. Five cases (5.5%) of lifetime DMDD were found (three from MDDoff, the rest from BDoff). Completion times for the Stroop test-TBAG form were ranked as: BDoff > MDDoff > Hoff. In the emotional Stroop test, the BDoff responded significantly later and had significantly reduced correct responses. CONCLUSION: Rates of lifetime DMDD were similar in the MDDoff and BDoff groups. BDoff may experience greater difficulties in resolving cognitive and emotional conflicts.

Sociodemographic and Clinical Features of Disruptive Mood Dysregulation Disorder: A Chart Review.

OBJECTIVE: Disruptive mood dysregulation disorder (DMDD) is a novel diagnosis listed in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) to encompass chronic and impairing irritability in youth, and to help its differentiation from bipolar disorders. Because it is a new entity, treatment guidelines, as well as its sociodemographic and clinical features among diverse populations, are still not elucidated. Here, DMDD cases from three centers in Turkey are reported and the implications are discussed. METHODS: The study was conducted at the Abant Izzet Baysal University Medical Faculty Department of Child and Adolescent Psychiatry (Bolu), and American Hospital and Bengi Semerci Institute (Istanbul) between August 2014 and October 2014. Records of patients were reviewed and features of patients who fulfilled criteria for DMDD were recorded. Data were analyzed with SPS Version 17.0 for Windows. Descriptive analyses, χ(2) test, and Mann-Whitney U test were used for analyses. Diagnostic consensus was determined via Cohen's κ constants. p was set at 0.01. RESULTS: Thirty-six patients (77.8 % male) fulfilled criteria for DMDD. κ value for consensus between clinicians was 0.68 (p = 0.00). Mean age of patients was 9.0 years (S.D. = 2.5) whereas the mean age of onset for DMDD symptoms was 4.9 years (S.D. = 2.2). Irritability, temper tantrums, verbal rages, and physical aggression toward family members were the most common presenting complaints. CONCLUSIONS: Diagnostic consensus could not be reached for almost one fourth of cases. Most common reasons for lack of consensus were problems in clarification of moods of patients in between episodes, problems in differentiation of normality and pathology (i.e., symptoms mainly reported in one setting vs. pervasiveness), and inability to fulfill frequency criterion for tantrums.

The comorbidity of reduplicative paramnesia, intermetamorphosis, reverse-intermetamorphosis, misidentification of reflection, and capgras syndrome in an adolescent patient.

Delusional misidentification syndromes may be superimposed on neurological or psychiatric disorders and include delusional beliefs that the people, objects, or places around the patient change or are made to change with one another. In this paper, an adolescent patient displaying Capgras syndrome, metamorphosis, reverse-intermetamorphosis, misidentification of reflection, and reduplicative paramnesia was presented. The findings that our patient struggled with visuospatial tests applied in the acute phase as well as the observation that she refused to meet her family face-to-face while accepting to speak on the phone may support the role of right hemisphere and visuospatial functions in the development of those syndromes. Further studies or case series evaluated more extensively are needed to reveal the relationship between right hemisphere functions and delusional misidentification syndromes.