Mood Disorders

Depressive disorders are characterized by a sad, empty, or irritable mood and accompanied by cognitive and physical symptoms. This group includes major depressive disorder (MDD), persistent dysphoric disorder (previously dysthmia), and disruptive mood dysregulation disorder (DMD).

Major depressive disorder affects approximately 2% of children, 4-8% of adolescents, and approximately 7% of adults. Adolescent girls and women are about twice as likely as males to experience depression. Major depressive disorder may also be associated with irritability and physical symptoms such as body pains. MDD is associated with impairments in school, work, relationships, and self-care.

Persistent dysphoric disorder affects approximately 0.5% of individuals and involves low mood that follows a more chronic course and over a longer period of time than major depressive disorder. Because of the chronic nature of this disorder, it may become part of the day-to-day experience of an individual and affect work, school, and relationships to varying degrees.

Key Symptoms of Mood Disorders

• Low mood and sadness most of the day
• Loss of interest and pleasure in activities
• Appetite changes (increase or decrease in appetite and weight)
• Sleep disturbance (increase or decrease) nearly every day
• Decreased energy
• Feelings of being worthless or excessive feelings of guilt
• Problems concentrating
• Persistent thoughts of death or suicide

Disruptive mood dysregulation was newly defined in the latest DSM-5; it aims to classify children between the age of 6 and 18 with extreme mood dysregulation and associated behavioral difficulties. Of note, symptoms of this disorder are characterized as frequently extreme in their emotional reactions and behaviors, in ways that are inconsistent with the situation, the child's age and the child's developmental level. It is estimated that 2-5% of children and adolescents experience significant disruptive mood dysregulation, with higher prevalence found in males and school-age children. Though prevalence rates have not yet been definitively studied, it has been estimated that the prevalence among children and adolescents is 2-5%, with higher prevalence in males and school-age children.

Key Symptoms of Disruptive Mood Dysregulation

• Frequent, severe temper outbursts
• Chronic and severe irritability, without clear trigger or cause
• Low frustration tolerance
• Frequent behavioral problems at school, home, and/or with peers