Irritability in youth: Trauma, maltreatment, and bullying in mood disorders

Objective: Disruptive Mood Dysregulation Disorder (DMDD) is characterized by irritability and anger outbursts, categorized under depressive disorders along with Major Depressive Disorder (MDD) in DSM-5. This study aims to investigate exposure to peer bullying and trauma in irritable youth with DMDD and compare it with those with MDD and healthy controls. Methods: This cross-sectional study included 313 participants aged 12-17 (DMDD: 103, MDD: 105, healthy controls: 105; mean age 15.0 +/- 1.6). The diagnosis was established using the Schizophrenia for School-Aged Children Present and Lifetime Version (K-SADS-PL) semi-structured interview. The Olweus Bullying Questionnaire, Childhood Trauma Questionnaire, and sociodemographic forms were utilized. Results: Both DMDD and MDD groups experienced significantly more physical, sexual, and emotional abuse, as well as physical and emotional neglect, compared to the healthy control group. Among the DMDD group, 34.9% were bullies, 42.7% were victims, and 18.4% were bully-victims. Conclusion: Adolescents diagnosed with DMDD are at increased risk for experiencing peer bullying and trauma. Emotional dysregulation and intense outbursts of anger predispose these individuals to both perpetrate and fall victim to peer bullying, as well as to become bully-victims. Including irritable adolescents in peer bullying intervention programs may be beneficial. Additionally, considering the elevated risk of anger outbursts and irritability in individuals exposed to trauma, they should be closely monitored.