nia or hypomania.
J. The behaviors do not occur exclusively during an episode of major depressive disorder
and are not better explained by another mental disorder (e.g., autism spectrum disor-
der, posttraumatic stress disorder, separat ion anxiety disorder, persistent depressive
disorder [dysthymia]).
Note:  This diagnosis cannot coexist with oppositional defiant disorder, intermittent ex-
plosive disorder, or bipolar disorder, though it can coexist with others, including major
depressive disorder, attention-deficit/hy peractivity disorder, conduct disorder, and
substance use disorders. Individuals whose symptoms meet criteria for both disruptive
mood dysregulation disorder and oppositional defiant disorder should only be given the
diagnosis of disruptive mood dysregulation disorder. If an individual has ever experi-
enced a manic or hypomanic episode, the diagnosis of disruptive mood dysregulation
disorder should not be assigned. 
K. The symptoms are not attributable to the physiological effects of a substance or to an-
other medical or neurological condition.
Diagnostic Features
The core feature of disruptive mood dysregulat ion disorder is chronic, severe persistent ir-
ritability. This severe irritability has two prominent clinical mani festations, the first of
which is frequent temper outbursts. These ou tbursts typically occur in response to frus-
tration and can be verbal or behavioral (the la tter in the form of aggression against prop-
erty, self, or others). They must occur frequent ly (i.e., on average, three or more times per
week) (Criterion C) over at least 1 year in at least two settings (Criteria E and F), such as in
the home and at school, and th ey must be developmentally inappropriate (Criterion B).