Comparison of clinical, temperamental, and sleep characteristics between disruptive mood dysregulation disorder and major depressive disorder in children and adolescents

Aim: The study aimed to investigate the clinical characteristics, temperament and character features, comorbidities, medication use, and sleep quality of children and adolescents aged between 6-18 diagnosed with Disruptive Mood Dysregulation Disorder (DMDD) and compare them with cases diagnosed with Major Depressive Disorder (MDD). Material and Methods: The study included 106 cases diagnosed with DMDD and 127 cases diagnosed with MDD who presented to the child and adolescent psychiatry outpatient clinic within an 12-month period based on the K-SADS PL assessment. For the evaluation of cases, the Children's Temperament and Character Inventory, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Strengths and Difficulties Child Form, and Children's Depression Rating Scale for children; and sociodemographic form and Strengths and Difficulties Parent Form for parents were used. Results: The mean age of the DMDD group was 14.5 ± 2.09, while it was determined as 15.0 ± 1.56 for the MDD group. According to the assessment of temperament and character features, the scores of cases in the MDD group in the areas of harm avoidance, reward dependence, and cooperation were statistically significantly higher than those in the DMDD group (p<0.05). The sleep quality of cases in the MDD group was found to be lower, sleep duration shorter, and daytime sleepiness higher compared to the DMDD group. In the DMDD group, the most commonly used medication group, with a rate of 84.4%, is oral antipsychotic drugs; among these, risperidone is the most preferred with 61.3%. In the treatment process of cases in the DMDD group, significantly more antipsychotic, mood stabilizer, and stimulant drugs are used compared to the MDD group (p<0.05). Conclusion: Under the heading of Depressive Disorders in DSM-5, DMDD and MDD, frequently confused in clinical practice, exhibit different temperament and character features, and sleep quality. Despite cases diagnosed with DMDD having intense emotional dysregulation, they are treated more with antipsychotic drugs rather than antidepressants and mood stabilizers compared to the MDD group. Keywords: Disruptive Mood Dysregulation Disorder, temperament, character, sleep, Major Depressive Disorder