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.

CH-M13-2506

The patient is a 13 Y year-old male with a history of fetal alcohol syndrome, separation anxiety, ADHD, RAD, sensory processing difficulty, DMDD, conduct disorder, and ODD who presents to the ER on 12/2 via law enforcement for assessment of aggression, suicidal, and homicidal ideation after physically assaulting his adoptive mom and brother and threatening to use a knife or gun to hurt the family when they weren’t looking. The patient made threats to kill himself with a colored pencil. The patient has aggressive outbursts several times per day when he is told no.

The patient has a long history of psychiatric services including residential at Northwoods x3, inpatient hospitalization x1, group home placement, PHP and further outpatient services. The county is currently in the process of developing an individual home for him which is thought to be completed in January though still requires licensing.

RMC-M11-2238

Ward of the state-currently under Wright County Guardianship. Parental rights have been terminated. History of aggressive behavior with homicidal and suicidal comments towards multiple people/on multiple occasions. On 11/15/23, patient was sent to a “calming room” at his school due to throwing a ball at another students face. This caused him to miss out on an outdoor activity that he wanted to attend. Patient was upset and punched one of his teachers (mental health support services personnel) in the nose, causing a broken nose. Had been living with bio-grandparents prior to this incident. He has been removed from foster homes in the past due to homicidal threats to the foster parents/others in the home.

HCMCH-M17-2402

attempted strangulation with the dog leash. HX of MDD, PTSD, ADHD & anxiety.

AH-F13-2355

Emotional dysregulation, high emotional reactivity in the home. Transgender. Housing insecure – soon to be evicted. Been in hospital 3 times this year. Recommend residential treatment. Meeting with mom today 12/22/22. Qualified person process can take up to 30 days.

AH-F15-2351

history of running, trauma, generational trauma, emotional dysregulation. Rec CRTC level 6 – barrier to placement. Waiting on County for review and to change to another county agent.

C8SM8SP-M12-2334

Emotional dysregulation, discharged from crisis respite home due to aggressive incident. Frequent episodes of dysregulation around electronics. Has been calm & cooperative in our hospital. Mom’s rights are terminated, but she had daily phone contact and monthly visits.

AH-F17-2296

substance use, dysregulation, personality struggles and mania. Waiting for residential. Struggles with Substance dependance. ED. emotional disreg. Level 5 resid. being recommended. Accepted to VOA CRTC, 2-4 week wait. Discharging to home to wait for funding.

MHF-M15-2183

Patient is presenting to the ED for the following concerns: self-harm. Patient has a history of self-harm, through primarily biting his arm, punching other things or scraping himself with a tack. Mom reported that today was the first time he self-harmed with a blade. Mom reporting increased aggression in the home and at school and feels that patient needs inpatient. Mom explained the patient is in a level 4 school setting. He recently did PHP at Prairie Care and was discharged after three days due to concerns about aggression and inappropriate sexual comments. Mom shared the patient has made comments about wanting to strangle others.
Mom explained that patient may already be on the waitlist for the Village Ranch residential treatment in Cokato. They are also exploring North Home in Bemidji. Mom reported that patient has been diagnosed with ADHD, ODD, PTSD and ASD. She also wonders about FASD due to his biological mothers, drug and alcohol use. Patient was adopted at age 7 by his adopted mom and adopted dad. Mom was his PCA in his last foster home for one year before adoption.

MCR-M16-1842

Long history of impulsive behavior and emotional dysregulation in the context of in utero substance exposure, prematurity, and repeated disruption of parental caregiver relationships. The current history suggests that he functioned fairly well over the last couple of years with relatively low level mental health services – highly experienced foster parent, individual therapy every 1-2 weeks, and occasional pharmacology. However, he began using cannabis more regularly and was unable to stop use when limits were set, leading to disruption of his foster placement. He has had significant dysregulation in a shelter and then crisis center setting since losing his foster home placement, including threatening peers, brandishing makeshift weapons, destroying property, and then finally physically attacking a peer (we do not have information about what provoked this) leading to his being sent to the ED. He has been consistently calm and polite here, though withdrawn, without evidence of clear active mood, psychotic, or anxiety disorder that would indicate a need for psychiatric hospitalization.