supported. This difference in prevalence betw een males and females differentiates disrup-
tive mood dysregulation disord er from bipolar disorder, in which there is an equal gender
prevalence.
Suicide Risk
In general, evidence documenting suicidal be havior and aggression, as well as other se-
vere functional consequences, in disruptive mood dysregulation diso rder should be noted
when evaluating children with chronic irritability. 
Functional Consequences of 
Disruptive Mood Dy sregulation Disorder
Chronic, severe irritability, su ch as is seen in disruptive mood dysregulation disorder, is
associated with marked disruption in a child’ s family and peer relationships, as well as in
school performance. Because of their extrem ely low frustration tole rance, such children
generally have difficulty succeeding in school; they are often unable to participate in the
activities typically enjoyed by healthy children;  their family life is severely disrupted by
their outbursts and irritability; and they have trouble initiating or sustaining friendships.
Levels of dysfunction in childr en with bipolar disorder and disruptive mood  dysregulation
disorder are generally comparable. Both condit ions cause severe disruption in the lives of
the affected individual and their families. In  both disruptive mood dysregulation disorder
and pediatric bipolar disorder, dangerous behavi or, suicidal ideation or suicide attempts,
severe aggression, and psychiatric hospitalization are common.
Differential Diagnosis
Because chronically irritable children and adolescents typically present with complex histo-
ries, the diagnosis of disruptive mood dysreg ulation disorder must be made while consid-
ering the presence or absence of multiple ot her conditions. Despite the need to consider