Irritability as an important non-specific symptom to evaluate in childhood mental health
Main Article Content
Abstract
Objective: To examine the symptom irritability reported in Mexican children aged fourto twelve in a series of studies at general practice and in the general population using the Brief Screening and Diagnosis Questionnaire (CBTD for its initials in Spanish) in order to identify probable syndromes and its association with internalizing and externalizing problems.
Material and Methods: A combined base of six studies (N=1,881) carried out between 2005 and 2018 was compared with the 1995 population study at Mexico City (N=1,223). The total prevalence of three probable irritability syndromes was obtained for sex and age group. The strength of the association between these irritability syndromes and internalizing and externalizing problems as defined by the CBTD was obtained.
Results: Irritability was six to eleven times higher than in 1995, prevailing in the most symptomatic cases. The association with externalizing syndromes was three to four times higher and two to six times higher with internalizing syndromes.
Conclusions: The three syndrome definitions seem to adequately address childhood irritability detecting clinically significant cases and those most in need of care.
Keywords:
mental health, children, symptoms, syndromes, psychopathology, questionnaire, screening, Mexico
Article Details
How to Cite
CARAVEO-ANDUAGA, Jorge Javier; GAYTÁN FLORES, Filiberto Itzcóatl.
Irritability as an important non-specific symptom to evaluate in childhood mental health.
Medical Research Archives, [S.l.], v. 11, n. 11, nov. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4588>. Date accessed: 16 may 2024.
doi: https://doi.org/10.18103/mra.v11i11.4588.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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21. Caraveo-Anduaga J. Intergeneration familial risk and psychosocial correlates for anxiety syndromes in children and adolescents in a developing country. In: Ágnes Szirmai ed. Anxiety and related disorders. INTECH open Access Publisher; 2011: 49-68.
22. Caraveo J. Familial Risk Across Three Generations and Psychosocial Correlates for Developing Psychopathology in a Changing World. J Child Adolesc Behav. 2014; 2(2):1-8. doi:10.4172/2375-4494.1000131.
23. Humphreys KL, Schouboe SNF, Kircanski K, Leibenluft E, Stringaris A, Gotlib IH. Irritability, Externalizing, and Internalizing Psychopathology in Adolescence: Cross-Sectional and Longitudinal Associations and Moderation by Sex. J Clin Child Adolesc Psychol. 2019; 48(5):781-789. doi:10.1080/ 15374416.2018.1460847
24. Deveney CM, Hommer RE, Reeves E, et al. A prospective study of severe irritability in youths: 2- and 4-year follow-up. Depress Anxiety. 2015; 32(5):364-372. doi:10.1002/ da.22336
25. Rappaport LM, Carney DM, Brotman MA, et al. A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes. J Clin Child Adolesc Psychol. 2020; 49(4):524-534. doi:10.1080/15374416 .2018.1514612
26. Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review. J Am Acad Child Adolesc Psychiatry. 2016; 55(7):556-570. doi: 10.1016/j.jaac.2016.04.014
27. Dirección General de Información en Salud DGIS. Defunciones Cifras Oficiales Definitivas. Cubos dinámicos de información 1998-2020 INEGI/SS. Available at: http://www.dgis.salud.gob.mx/contenidos/basesdedatos/bdc_defunciones_gobmx.html. Accessed September 21, 2022
28. Salum GA, Mogg K, Bradley BP, et al. Association between irritability and bias in attention orienting to threat in children and adolescents. J Child Psychol Psychiatry. 2017; 58(5):595-602. doi:10.1111/jcpp.12659
29. Zachary C, Jones DJ. The Role of Irritability in the Treatment of Behavior Disorders: A Review of Theory, Research, and a Proposed Framework. Clin Child Fam Psychol Rev. 2019;22(2):197-207. doi:10.1007 /s10567-018-00272-y
30. Kahle S, Mukherjee P, Dixon JF, Leibenluft E, Hinshaw SP, Schweitzer JB. Irritability Predicts Hyperactive/Impulsive Symptoms Across Adolescence for Females. Res Child Adolesc Psychopathol. 2021; 49(2):185-196. doi:10.1007/s10802-020-00723-7
31. Galera C, Orri M, Vergunst F, et al. Developmental profiles of childhood attention-deficit/hyperactivity disorder and irritability: association with adolescent mental health, functional impairment, and suicidal outcomes. J Child Psychol Psychiatry. 2021; 62(2):232-243. doi:10.1111/jcpp.13270
32. Evans SC, Roberts MC, Keeley JW, et al. Diagnostic classification of irritability and oppositionality in youth: a global field study comparing ICD-11 with ICD-10 and DSM-5. J Child Psychol Psychiatry. 2021; 62(3):303-312. doi:10.1111/jcpp.13244
33. Burke JD, Boylan K, Rowe R, et al. Identifying the irritability dimension of ODD: Application of a modified bifactor model across five large community samples of children. J Abnorm Psychol. 2014; 123(4):841-851. doi:10.1037/a0037898
2. Rutter M, Shaffer D. DSM-III. A step forward or back in terms of the classification of child psychiatric disorders?. J Am Acad Child Psychiatry. 1980; 19(3):371-394. doi:10.1016/ s0002-7138(09)61060-8
3. Wenar C, Kerig P. Developmental Psychopathology. From Infancy through Adolescence. 5th ed. Boston: McGraw-Hill; 2006.
4. Caraveo-Anduaga J, Martínez N, Erazo J. What has changed in children’s behavioural problems reported in Mexico City over a 13-year period? In: Bhugra D, Ventriglio A, Castaldelli-Maia J, McCay L, eds. Urban Mental Health. Oxford University Press; 2019: 204-225.
5. Elvin OM, Modecki KL, Finch J, Donnolley K, Farrell LJ, Waters AM. Joining the pieces in childhood irritability: Distinct typologies predict conduct, depressive, and anxiety symptoms. Behav Res Ther. 2021; 136: 103779. doi:10.1016/j.brat.2020.103779
6. Sorcher LK, Goldstein BL, Finsaas MC, Carlson GA, Klein DN, Dougherty LR. Preschool Irritability Predicts Adolescent Psychopathology and Functional Impairment: A 12-Year Prospective Study. J Am Acad Child Adolesc Psychiatry. 2022; 61(4):554-564.e1. doi:10.1016/j.jaac.2021.08.016
7. American Psychiatric Association. Diagnostic and statistical manual of mental disorders.4th text rev. ed. Washington, DC: American Psychiatric Association; 2000.
8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
9. Dougherty LR, Smith VC, Bufferd SJ, Kessel EM, Carlson GA, Klein DN. Disruptive mood dysregulation disorder at the age of 6 years and clinical and functional outcomes 3 years later. Psychol Med. 2016; 46(5):1103-1114. doi:10.1017/S0033291715002809
10. Bruno A, Celebre L, Torre G, et al. Focus on Disruptive Mood Dysregulation Disorder: A review of the literature. Psychiatry Res. 2019; 279:323-330. doi:10.1016/j.psychres. 2019.05.043
11. Fourneret P, Desombre H. Le concept d’irritabilité chronique sévère : une dimension clinique à prendre en compte chez l’enfant et l’adolescent [The Severe Chronic Irritability Concept: A clinical dimension to consider in child and adolescent]. Encephale. 2017; 43(2) :187-191. doi:10.1016/j.encep.2016.08.007
12. Leibenluft E, Stoddard J. The developmental psychopathology of irritability. Dev Psychopathol. 2013; 25(4 Pt 2):1473-1487. doi:10.1017/S0954579413000722
13. Wiggins JL, Briggs-Gowan MJ, Estabrook R, et al. Identifying Clinically Significant Irritability in Early Childhood. J Am Acad Child Adolesc Psychiatry. 2018; 57(3):191-199.e2. doi:10.1016/j.jaac.2017.12.008
14. Caraveo J, Martínez N, Rivera E. Un modelo para estudios epidemiológicos sobre la salud mental y la morbilidad psiquiátrica. Salud Ment. 1998; 21(1): 48-57.
15. Caraveo-Anduaga J. “Cuestionario Breve de Tamizaje y Diagnóstico de Problemas de Salud Mental en Niños y Adolescentes: confiabilidad, estandarización y validez de construcción”. Salud Ment. 2006; 29(6): 65-72.
16. Caraveo-Anduaga J. “Cuestionario Breve de Tamizaje y Diagnóstico de Problemas de Salud Mental en Niños y Adolescentes: algoritmos para síndromes y su prevalencia en la Ciudad de México”. Salud Ment. 2007; 30(1): 48-55.
17. Caraveo-Anduaga JJ, López-Jiménez JL, Soriano-Rodríguez A, López-Hernández JC, Contreras-Garza A, Reyes-Mejía A. Eficiencia y validez concurrente del CBTD para la vigilancia de la salud mental de niños y adolescentes en un centro de atención primaria de México [Concurrent validity and efficiency of the CBTD for the surveillance of mental health on children and adolescents at a primary health care center in Mexico]. Rev Invest Clin. 2011;63(6):590-600.
18. Caraveo-Anduaga J. Vigilando la salud mental infantil en atención primaria. Norderstedt, Germany: Editorial Académica Española; 2016.
19. Benjet C, Borges G, Medina-Mora ME, Zambrano J, Aguilar-Gaxiola S. Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey. J Child Psychol Psychiatry. 2009; 50(4):386-395. doi:10.1111/ j.1469-7610.2008.01962.x
20. Benjet C, Borges G, Medina-Mora ME, Zambrano J, Cruz C, Méndez E. Descriptive epidemiology of chronic childhood adversity in Mexican adolescents. J Adolesc Health. 2009; 45(5):483-489. doi:10.1016/j.jadohealth .2009.03.002
21. Caraveo-Anduaga J. Intergeneration familial risk and psychosocial correlates for anxiety syndromes in children and adolescents in a developing country. In: Ágnes Szirmai ed. Anxiety and related disorders. INTECH open Access Publisher; 2011: 49-68.
22. Caraveo J. Familial Risk Across Three Generations and Psychosocial Correlates for Developing Psychopathology in a Changing World. J Child Adolesc Behav. 2014; 2(2):1-8. doi:10.4172/2375-4494.1000131.
23. Humphreys KL, Schouboe SNF, Kircanski K, Leibenluft E, Stringaris A, Gotlib IH. Irritability, Externalizing, and Internalizing Psychopathology in Adolescence: Cross-Sectional and Longitudinal Associations and Moderation by Sex. J Clin Child Adolesc Psychol. 2019; 48(5):781-789. doi:10.1080/ 15374416.2018.1460847
24. Deveney CM, Hommer RE, Reeves E, et al. A prospective study of severe irritability in youths: 2- and 4-year follow-up. Depress Anxiety. 2015; 32(5):364-372. doi:10.1002/ da.22336
25. Rappaport LM, Carney DM, Brotman MA, et al. A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes. J Clin Child Adolesc Psychol. 2020; 49(4):524-534. doi:10.1080/15374416 .2018.1514612
26. Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review. J Am Acad Child Adolesc Psychiatry. 2016; 55(7):556-570. doi: 10.1016/j.jaac.2016.04.014
27. Dirección General de Información en Salud DGIS. Defunciones Cifras Oficiales Definitivas. Cubos dinámicos de información 1998-2020 INEGI/SS. Available at: http://www.dgis.salud.gob.mx/contenidos/basesdedatos/bdc_defunciones_gobmx.html. Accessed September 21, 2022
28. Salum GA, Mogg K, Bradley BP, et al. Association between irritability and bias in attention orienting to threat in children and adolescents. J Child Psychol Psychiatry. 2017; 58(5):595-602. doi:10.1111/jcpp.12659
29. Zachary C, Jones DJ. The Role of Irritability in the Treatment of Behavior Disorders: A Review of Theory, Research, and a Proposed Framework. Clin Child Fam Psychol Rev. 2019;22(2):197-207. doi:10.1007 /s10567-018-00272-y
30. Kahle S, Mukherjee P, Dixon JF, Leibenluft E, Hinshaw SP, Schweitzer JB. Irritability Predicts Hyperactive/Impulsive Symptoms Across Adolescence for Females. Res Child Adolesc Psychopathol. 2021; 49(2):185-196. doi:10.1007/s10802-020-00723-7
31. Galera C, Orri M, Vergunst F, et al. Developmental profiles of childhood attention-deficit/hyperactivity disorder and irritability: association with adolescent mental health, functional impairment, and suicidal outcomes. J Child Psychol Psychiatry. 2021; 62(2):232-243. doi:10.1111/jcpp.13270
32. Evans SC, Roberts MC, Keeley JW, et al. Diagnostic classification of irritability and oppositionality in youth: a global field study comparing ICD-11 with ICD-10 and DSM-5. J Child Psychol Psychiatry. 2021; 62(3):303-312. doi:10.1111/jcpp.13244
33. Burke JD, Boylan K, Rowe R, et al. Identifying the irritability dimension of ODD: Application of a modified bifactor model across five large community samples of children. J Abnorm Psychol. 2014; 123(4):841-851. doi:10.1037/a0037898