Psychiatric Diagnosis: Disruptive Mood Dysregulation Disorder (DMDD)

DMDD is a psychiatric diagnosis that applies to children and adolescents who exhibit severe temper outbursts and persistent irritability. It is often associated with difficulties in regulating emotions.

MCR-F16-279

History of PTSD, RAD, ODD, mood issues, adopted at age 6, multiple foster placements prior. Struggling for many years, 4 suicide attempts fall 2021, placed in a shelter in St Paul and targeted by a sex trafficker and eloped for 2 weeks, repeatedly assaulted, given drugs. Admitted to SEY program at Heartland Girls Ranch March 2022, unsuccessfully discharged October 2022 after assaulting a peer. Receiving school-based CD services through ALC, but no mental health services. Case manager working on residential but no success. Admitted to hospital 1/23/23 after massive OD triggered by breakup. Medically cleared 1/27, declined by all inpatient psych because of assault history. Suicidality has resolved, no behavioral issues. She eloped from the peds floor on 3/16/23 and had to be brought back to the ED by law enforcement. Hospitalization not recommended; county looking at outside placement options.

MHF-M16-350

Patient presented from group home with aggression, breaking things. He has chronic aggressive behaviors. He was admitted to Hawthorn Center state hospital in 6/21-7/22. During his admission, patient’s mom passed away and he was placed in Beacon Crisis Residence. Patient had a prolonged stay in UMMC ED September 2022-October 2022 and was discharged to RTC in TN. Patient was discharged from the facility in TN due to concerns with the facility and was returned MN. He was brought from the airport to Children’s Hospital on 1/11/23-1/13/23 and was discharged and immediately brought to UMMC ED by parent and county worker. He was in UMMC ED 1/13/23-2/7/23 and was started on Zyprexa ODT due to cheeking medications. He was eventually discharged to crisis home. Patient then returned for further concerns of medication non adherance and exacerbation of psychotic symptoms. He had inpatient admission on Inpatient mental health at UMMC from 2/15/23-3/12/23. Patient was discharged to respite house with additional wrap around services. Patient has had 4 ED encounters since that time. Patient discharged to his group home on 5/1/23 and returned to ED on 5/2/23 due to aggressive behaviors. Patient is unable to return to group home.

CH-M8-901

Patient with a history of ADHD, DMDD, and trauma that presents after making verbal suicide threat and gesture of putting his hands around his neck. Has a history of suicide statements and self injury when angry. Does not require inpatient hospitalization though is unable to return to foster home. There is difficulty in finding an accepting foster placement.

D/C to new foster home on 6/2/23

MHF-F12-635

Patient presented to the ED from CRTC due to increased aggressive behaviors in the facility towards staff and was unable to return to the facility. Patient not safe to return home due to behaviors and case manager is pursuing residential treatment.

C8SM8M-M8-308

Presents with dysregulation, agitation, aggression, threats of SI/SIB. extensive mental health history. Sexual abuse at early age. In and out of residential treatment. He doesn’t meet inpatient requirement. Mom unable to meet his needs at this time. Mom working with county to find residential placement.