Harvard Mental Health Letter

Ask the doctor: What is temper dysregulation disorder?

Q. My 8-year-old son was diagnosed with bipolar disorder several years ago. Now a new therapist thinks the problem might be temper dysregulation disorder. What is that? How is it treated?

A. In the draft version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), now undergoing review, temper dysregulation disorder with dysphoria is proposed as a new diagnosis. According to the draft definition, symptoms appear between ages 6 and 10, and include verbal rages, aggressive behaviors, and other outbursts that occur at least three times per week for at least 12 months. The child is also persistently irritable, angry, or sad.

The new diagnosis arose in part because of concern that bipolar disorder is over-diagnosed in children. Members of the DSM-V Childhood and Adolescent Disorders Work Group believe that, for most of these children, the term temper dysregulation disorder with dysphoria is a better fit.

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