Perinatal and postnatal risk factors for disruptive mood dysregulation disorder at age 11: 2004 Pelotas Birth Cohort Study

BACKGROUND: To date, there have been few studies of DMDD examining the risk factors during gestation and during the first years of life. We assessed the perinatal and postnatal risk factors associated with the occurrence of disruptive mood dysregulation disorder (DMDD) by 11 years of age. METHODS: Prospective longitudinal study. Mothers completed a standardized questionnaire shortly after childbirth. We used the Development and Well-Being Assessment, administered to the mothers or legal guardians, to identify DMDD among the 11-year-old subjects. We also employed logistic regression to perform bivariate and multivariate analyses, using a theoretical model of conceptual analysis. RESULTS: We evaluated data related to 3563 subjects at 11 years of age. The prevalence of DMDD was 2.5% (95% CI=2.0–3.0). After adjusting for potential confounders, we found that the early risk factors for the development of DMDD by 11 years of age were maternal mood symptoms during pregnancy, maternal depression during the first years after childbirth, and low maternal level of education. LIMITATIONS: We were unable to evaluate the genetic characteristics of the family at the birth of each subject, and there were no data available regarding the prenatal or postnatal mental health of the fathers. CONCLUSIONS: The prevalence of DMDD in early adolescence is low and its risk factors are related to potentially modifiable maternal characteristics. Scientific evidence indicates that DMDD is a major predictor of other psychiatric disorders, especially depression and anxiety. Effective prenatal and postnatal mental health care could prevent mental disorders in offspring.