Emotional conflict resolution and prevalence of disruptive mood dyregulation disorder in adolescent offspring of parents diagnosed with recurrent depressive disorder and bipolar disorder and matched healthy controls

Aim:Recent studies demonstrated that episodic irritability in childhood is related with bipolar disorder in adulthood while severe and chronic irritability is more closely related with unipolar depression and anxiety disorders in adulthood (Stringaris et al. 2009, 2012). In accordance with those studies the novel diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) is listed under the heading of Depressive Disorder in DSM-5. In this study, it was aimed to evaluate the psychopathologies of parents diagnosed with Recurrent Major Depressive Disorder and Bipolar Disorder with structured interviews, to determine the prevalence of DMDD diagnosis and to evaluate the resolution of cognitive (Stroop Test- TBAG Form) and emotional (Emotional Stroop) conflicts in comparison with children of healthy controls. Method:Records of adult patients who applied to the study center in between January and June 2015 and diagnosed with Depressive and Related Disorders and Bipolar and related disorders were retrospectively reviewed. After those reviews, patients who were judged to fulfill criteria for Recurrent Major Depressive disorder and Bipolar Disorder were contacted and those who did not fulfill exclusion criteria with offspring between 12-16 years were evaluated with SCID. As a result, 90 offspring from 81 families from recurrent depressive disorder, bipolar disorder and healthy control groups were included in the study. The children were evaluated with K-SADS also, the DMDD module which was not listed in the K-SADS but was developed by the investigators according to DSM-5 criteria was given after preliminary analyses. TBAG form of the Stroop Test was given to evaluate cognitive conflict resolution while emotional stroop test which was developed by the investigators via word- face paradigm was employed after appropriate preliminary analyses. Results:The most common diagnosis according to K-SADS evaluations was ADHD (18.9 % ) followed by Separation Anxiety Disorder (10.1 %) and Oppositional Defiant Disorder (7.9 %). None of the children were diagnosed with mood disorders according to parental reports while according to children's reports 5.5 % fulfilled criteria for lifetime MDD. Among the whole sample questioned for DSM-5 DMDD criteria according to parental reports 5 cases (5.5 %) of lifetime DMDD were found. This rate was found to be 4.4 % (n=4) according to children's reports. Three of the DMDD cases according to parental reports were from UP while the rest was from the BP group. In accordance with previous reports (Mbekou et al. 2014), when children with Child Behavior Checklist- Dysregulation Profile T scores > 210 were judged to display a pathology characterized with problems in mood regulation problems, two cases each (2.2 %) in forms filled by both mothers and mothers were found to be in the pathological range. One of those was from the UP group while the other was from the BP group. Completion times for all cards in the Stroop Test- TBAG from was ranked as BP > UP > Controls. In the emotional Stroop test adolescent offpsring in the BP group were found to respond significantly later thatn those in UP and control groups (Mann-Whitney U test, Chi Square= 6.2, p=0.05). Conclusion:In this study, it was found that ADHD was the most common diagnosis in all groups via both parental and child reports, that 5 cases of DMDD (5.5 %) were found in the whole sample according to parental reports, that no significant difference for the DMDD diagnosis could be found between UP and BP groups, that offspring of parents with BP diagnosis displayed significantly longer response latencies in the Stroop Test- TBAG form, and that offspring of BP parents responded significantly later than the other two groups as well as committing sgnificantly more frequent errors. This difference however ceased to exist in the last trial block.