156 Depressive Disorders
Disruptive Mood Dysregulation Disorder
Diagnostic Criteria 296.99 (F34.8)
A. Severe recurrent temper outbursts manifested verbally (e.g., verbal rages) and/or be-
haviorally (e.g., physical aggression toward people or property) that are grossly out of
proportion in intensity or duration to the situation or provocation. 
B. The temper outbursts are inconsistent with developmental level.
C. The temper outbursts occur, on aver age, three or more times per week.
D. The mood between temper outbursts is persistently irritable or angry most of the day,
nearly every day, and is observable by others (e.g., parents, teachers, peers).
E. Criteria A–D have been present for 12 or more months. Throughout that time, the indi-
vidual has not had a period lasting 3 or more consecutive months without all of the
symptoms in Criteria A–D.
F. Criteria A and D are present in at least two of three settings (i.e., at home, at school,
with peers) and are severe in at least one of these.
G. The diagnosis should not be made for the first time before age 6 years or after age 18
years. 
H. By history or observation, the age at onset of Criteria A–E is before 10 years.
I. There has never been a distinct period lasting more than 1 day during which the full
symptom criteria, except duration, fo r a manic or hypomanic episode have been met.
Note:  Developmentally appropriate mood elevation, such as occurs in the context of a
highly positive event or its anticipation, should not be considered as a symptom of ma-
nia or hypomania.