Dysrégulation émotionnelle et comportementale sévère: Une nouvelle entité pour des enfants irritables?

Severe mood dysregulation is a relatively new diagnosis in the field of mental health. It is included into the DSM5 classification under the term DMDD for disruptive mood dysregulation disorder. Disruptive mood dysregulation disorder has been isolated in American and British studies on children's bipolar disorders. Afflicted children typically suffer from chronic irritability i.e. dysphoric or hypomanic-like symptoms, accompanied by an explosive outburst that interferes with their ability to function at home, in school, or with their friend. These disorders appear early and have chronic, non episodic evolution. These children are also characterized by a lack of emotional control and some behavioral dysregulation, preventing them to achieve secure attachment and euthymia. This article presents an overview of diagnostic criteria, the reasons which have supported the creation of the disruptive mood dysregulation disorder, and available research on this disorder. We emphasize the controversies in literature regarding so called "peadiatric bipolar disorder". The relations with other psychiatric comorbidities including attention deficit-hyperactivity disorder are also discussed. This review is illustrated with two case reports.