Temper dysregulation disorder with dysphoria. Is it prodrome of bipolar disorders or prodrome of depression?
Jolanta Rabe‑Jabłońska, Marta Gawłowska

Considering research results, many groups of experts who participate in preparations of a new edition of DSM (Diagnostic and Statistical Manual of Mental Disorders, DSM‑V) suggest introduction of new diagnostic categories, including temper dysregulation disorder with dysphoria – TDD. This suggestion provoked broad discussion both in the research community and among clinicians. Development of the criteria to diagnose TDD has a long history associated with the search for knowledge of prodromal symptoms of bipolar disorder, especially data on the specific clinical picture, duration and course of mania in children and adolescents. Observation of a group of adolescents with non‑episodic (chronic) irritability accompanied by constant problems with anger control in response to normal stimuli and some features resembling a classic form of mania allowed to create diagnostic criteria for TDD. Long‑term observations of people with this diagnosis showed that the disorder is most likely a predictor of a unipolar depression and anxiety disorders, but, interestingly, not a bipolar disorder in the adulthood. This conclusion is confirmed by the epidemiological data, results of genetic and neuropsychological testing and neuroimaging (fIMR). These findings offer important guidance for the treatment of people with symptoms of TDD.