irritable mood


Summary: Abnormal or excessive excitability with easily triggered anger, annoyance, or impatience.

Top Publications

  1. Ramos Jorge J, Pordeus I, Ramos Jorge M, Paiva S. Prospective longitudinal study of signs and symptoms associated with primary tooth eruption. Pediatrics. 2011;128:471-6 pubmed publisher
    ..Results of this study support the concept that the occurrence of severe signs and symptoms, such as fever, could not be attributed to teething. ..
  2. Rich B, Grimley M, Schmajuk M, Blair K, Blair R, Leibenluft E. Face emotion labeling deficits in children with bipolar disorder and severe mood dysregulation. Dev Psychopathol. 2008;20:529-46 pubmed publisher
    ..These deficits are associated with psychosocial impairments. Understanding the neural circuitry associated with face-labeling deficits has the potential to clarify the pathophysiology of these disorders. ..
  3. Stringaris A, Zavos H, Leibenluft E, Maughan B, Eley T. Adolescent irritability: phenotypic associations and genetic links with depressed mood. Am J Psychiatry. 2012;169:47-54 pubmed publisher
    ..57, 95% CI=0.45-0.69). [corrected]. These findings are consistent with the theory that genes with general effects underlie the relationship between irritability and depression. ..
  4. Vandrey R, Budney A, Hughes J, Liguori A. A within-subject comparison of withdrawal symptoms during abstinence from cannabis, tobacco, and both substances. Drug Alcohol Depend. 2008;92:48-54 pubmed
    ..Additional research is needed to replicate these findings and to further investigate the effects of abstaining from multiple drugs simultaneously. ..
  5. Dickstein D, Nelson E, McClure E, Grimley M, Knopf L, Brotman M, et al. Cognitive flexibility in phenotypes of pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2007;46:341-55 pubmed
    ..On the change task, NP-BD youths were slower to adapt than SMD subjects. Phenotypic differences in cognitive flexibility may reflect different brain/behavior mechanisms in these two patient populations. ..
  6. Rich B, Schmajuk M, Perez Edgar K, Fox N, Pine D, Leibenluft E. Different psychophysiological and behavioral responses elicited by frustration in pediatric bipolar disorder and severe mood dysregulation. Am J Psychiatry. 2007;164:309-17 pubmed
  7. Stringaris A, Goodman R. Three dimensions of oppositionality in youth. J Child Psychol Psychiatry. 2009;50:216-23 pubmed publisher
    ..35 [.32, .39]; teacher report: .40 [.39, .42]). The three dimensions of oppositionality have distinctive external correlates, suggesting they may also be differential predictors of aetiology, prognosis and treatment responsiveness. ..
  8. Hunt J, Birmaher B, Leonard H, Strober M, Axelson D, Ryan N, et al. Irritability without elation in a large bipolar youth sample: frequency and clinical description. J Am Acad Child Adolesc Psychiatry. 2009;48:730-9 pubmed publisher
  9. Stringaris A, Cohen P, Pine D, Leibenluft E. Adult outcomes of youth irritability: a 20-year prospective community-based study. Am J Psychiatry. 2009;166:1048-54 pubmed publisher
    ..The role of irritability in developmental psychiatry, and in the pathophysiology of mood and anxiety disorders specifically, should receive further study. ..

More Information


  1. Hardan A, Fung L, Libove R, Obukhanych T, Nair S, Herzenberg L, et al. A randomized controlled pilot trial of oral N-acetylcysteine in children with autism. Biol Psychiatry. 2012;71:956-61 pubmed publisher
    ..80; p < .001; d = .96). Data from this pilot investigation support the potential usefulness of NAC for treating irritability in children with autistic disorder. Large randomized controlled investigations are warranted. ..
  2. Stringaris A, Baroni A, Haimm C, Brotman M, Lowe C, Myers F, et al. Pediatric bipolar disorder versus severe mood dysregulation: risk for manic episodes on follow-up. J Am Acad Child Adolesc Psychiatry. 2010;49:397-405 pubmed
    ..4%]; 95% CI 0.52 to 0.72). These data suggest that, over an approximately 2-year follow-up period, youth with SMD are unlikely to develop (hypo-)manic or mixed episodes. ..
  3. Meyer T, Stanske B, Kochen M, Cordes A, Yüksel I, Wachter R, et al. Elevated serum levels of interleukin-10 and tumor necrosis factor ? [corrected] are both associated with vital exhaustion in patients with cardiovascular risk factors. Psychosomatics. 2010;51:248-56 pubmed publisher
  4. Feldens C, Faraco I, Ottoni A, Feldens E, Vitolo M. Teething symptoms in the first year of life and associated factors: a cohort study. J Clin Pediatr Dent. 2010;34:201-6 pubmed
    ..Pediatric dentists should be accessible and provide adequate orientation when symptoms can be managed at home or immediate referral to health services when more serious diseases are suspected. ..
  5. Stringaris A, Goodman R, Ferdinando S, Razdan V, Muhrer E, Leibenluft E, et al. The Affective Reactivity Index: a concise irritability scale for clinical and research settings. J Child Psychol Psychiatry. 2012;53:1109-17 pubmed publisher
    b>Irritable mood has recently become a matter of intense scientific interest...
  6. Fava M, Hwang I, Rush A, Sampson N, Walters E, Kessler R. The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15:856-67 pubmed publisher
    ..Further investigation is warranted of distinct family aggregation, risk factors and treatment response. Consideration should also be given to including irritability as a nondiagnostic symptom of adult MDD in DSM-V and ICD-11. ..
  7. Segebladh B, Borgström A, Nyberg S, Bixo M, Sundström Poromaa I. Evaluation of different add-back estradiol and progesterone treatments to gonadotropin-releasing hormone agonist treatment in patients with premenstrual dysphoric disorder. Am J Obstet Gynecol. 2009;201:139.e1-8 pubmed publisher
    ..Based on the findings of the present study, long-cycle add-back treatment to avoid frequent progestagen use appears to be most beneficial for patients with premenstrual dysphoric disorder. ..
  8. Owen R, Sikich L, Marcus R, Corey Lisle P, Manos G, McQuade R, et al. Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Pediatrics. 2009;124:1533-40 pubmed publisher
    ..Mean weight gain was 2.0 kg on aripiprazole and 0.8 kg on placebo at week 8. Aripiprazole was efficacious in children and adolescents with irritability associated with autistic disorder and was generally safe and well tolerated. ..
  9. Leigh E, Smith P, Milavic G, Stringaris A. Mood regulation in youth: research findings and clinical approaches to irritability and short-lived episodes of mania-like symptoms. Curr Opin Psychiatry. 2012;25:271-6 pubmed publisher
    ..The evidence base for their drug treatment has yet to be developed. CBT-based interventions to modify the processes of mood regulation may be a useful and well tolerated intervention for patients with these presentations. ..
  10. Stringaris A, Stahl D, Santosh P, Goodman R. Dimensions and latent classes of episodic mania-like symptoms in youth: an empirical enquiry. J Abnorm Child Psychol. 2011;39:925-37 pubmed publisher
    ..Our results carry implications for the nosology and psychosocial impairment associated with episodic mood changes in young people. ..
  11. Leibenluft E. Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. Am J Psychiatry. 2011;168:129-42 pubmed publisher
    ..and the hyperarousal symptoms characteristic of mania but who lack the well-demarcated periods of elevated or irritable mood characteristic of bipolar disorder...
  12. Stringaris A. Irritability in children and adolescents: a challenge for DSM-5. Eur Child Adolesc Psychiatry. 2011;20:61-6 pubmed publisher
    ..Finally, I critically discuss the recently proposed putative DSM-5 category of temper dysregulation disorder with dysphoria and make suggestions about future research directions. ..
  13. Stringaris A, Maughan B, Copeland W, Costello E, Angold A. Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study. J Am Acad Child Adolesc Psychiatry. 2013;52:831-40 pubmed publisher
    ..prevalence, developmental characteristics, associations with psychopathology, and longitudinal stability of irritable mood in childhood and adolescent depression...
  14. Perlis R, Fava M, Trivedi M, Alpert J, Luther J, Wisniewski S, et al. Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder. Acta Psychiatr Scand. 2009;119:282-9 pubmed publisher
    ..Bipolar spectrum features were not more common among those with irritability. Irritable depression is not a distinct subtype of MDD, but irritability is associated with greater overall severity, anxiety comorbidity and suicidality. ..
  15. Stringaris A, Goodman R. Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. J Am Acad Child Adolesc Psychiatry. 2009;48:404-12 pubmed publisher
    ..Our data suggest a developmental model of mental disorder whereby oppositionality is an interim shared manifestation of different dimensions of psychopathology with distinct outcomes. ..
  16. Brotman M, Rich B, Guyer A, Lunsford J, Horsey S, Reising M, et al. Amygdala activation during emotion processing of neutral faces in children with severe mood dysregulation versus ADHD or bipolar disorder. Am J Psychiatry. 2010;167:61-9 pubmed publisher
    ..These findings support the role of unique neural correlates in face-emotion processing among youths with bipolar disorder, ADHD, and severe mood dysregulation. ..
  17. Benazzi F. Possible bipolar nature of irritability in major depressive disorder. J Clin Psychiatry. 2005;66:1072; author reply 1073 pubmed
  18. Chatterjee A, Anderson K, Moskowitz C, Hauser W, Marder K. A comparison of self-report and caregiver assessment of depression, apathy, and irritability in Huntington's disease. J Neuropsychiatry Clin Neurosci. 2005;17:378-83 pubmed
    ..Caregiver assessment of patients' moods and apathy may be an acceptable alternative to patient self-report as patients' cognitive status worsens. ..
  19. Leibenluft E, Cohen P, Gorrindo T, Brook J, Pine D. Chronic versus episodic irritability in youth: a community-based, longitudinal study of clinical and diagnostic associations. J Child Adolesc Psychopharmacol. 2006;16:456-66 pubmed
    ..Episodic and chronic irritability in adolescents appear to be stable, distinct constructs. Further research is needed to elucidate the longitudinal associations of each with specific psychiatric diagnoses. ..
  20. Deckersbach T, Perlis R, Frankle W, Gray S, Grandin L, Dougherty D, et al. Presence of irritability during depressive episodes in bipolar disorder. CNS Spectr. 2004;9:227-31 pubmed
    ..Our results suggest that abnormal irritability is not limited to mania or mixed states. ..
  21. Perlis R, Fraguas R, Fava M, Trivedi M, Luther J, Wisniewski S, et al. Prevalence and clinical correlates of irritability in major depressive disorder: a preliminary report from the Sequenced Treatment Alternatives to Relieve Depression study. J Clin Psychiatry. 2005;66:159-66; quiz 147, 273-4 pubmed
    ..It is correlated with overall depression severity and thus may not represent a distinct depressive subtype per se. The impact of irritability on course and treatment outcome merits further study. ..
  22. Benazzi F, Akiskal H. Irritable-hostile depression: further validation as a bipolar depressive mixed state. J Affect Disord. 2005;84:197-207 pubmed
    ..Irritable-hostile depression as a variant of DMX deserves the benefit of what seems to work best in practice, i.e., anticonvulsant mood stabilizers and/or atypical antipsychotics. Formal treatment studies are very much needed. ..
  23. McHichi alami K, Tahiri S, Moussaoui D, Kadri N. [Assessment of premenstrual dysphoric disorder symptoms: population of women in Casablanca]. Encephale. 2002;28:525-30 pubmed
    ..These data are in accordance with the literature, confirming that this disorder is common and has a bad impact on mental health and on quality of life of the women suffering from PMDD. ..
  24. Mankoski R, Stockton G, Manos G, Marler S, McQuade R, Forbes R, et al. Aripiprazole treatment of irritability associated with autistic disorder and the relationship between prior antipsychotic exposure, adverse events, and weight change. J Child Adolesc Psychopharmacol. 2013;23:572-6 pubmed publisher
    ..Study of aripiprazole in the treatment of children and adolescents with autistic disorder. Registry: . Identifiers: NCT00332241 and NCT00337571. ..
  25. Adam T, Schamarek I, Springer E, Havel P, Epel E. Adiponectin and negative mood in healthy premenopausal and postmenopausal women. Horm Behav. 2010;58:699-704 pubmed publisher
    ..Mechanistic studies are needed to explore this potential relationship further. ..
  26. Rihmer Z, Gonda X, Akiskal K, Akiskal H. Affective temperament: a mediating variable between environment and clinical depression?. Arch Gen Psychiatry. 2007;64:1096-7 pubmed
  27. Bardel A, Wallander M, Wedel H, Svardsudd K. Age-specific symptom prevalence in women 35-64 years old: a population-based study. BMC Public Health. 2009;9:37 pubmed publisher
    ..Symptoms did not necessarily increase with age instead symptoms related to stress-tension-depression decreased. ..
  28. Li H, Chau C, Tang S. Can surrounding greenery reduce noise annoyance at home?. Sci Total Environ. 2010;408:4376-84 pubmed publisher
    ..And the effects of the perceived amount of greenery on noise annoyance reduction at home differ according to the setting of greenery to which participant perceived from individual home. ..
  29. Zhou Q, Lengua L, Wang Y. The relations of temperament reactivity and effortful control to children's adjustment problems in China and the United States. Dev Psychol. 2009;45:724-39 pubmed publisher
    ..Implications of the findings for the detection and intervention of adjustment problems in Chinese children are discussed. ..
  30. Garza D, Murphy M, Tseng L, Riordan H, Chatterjee A. A double-blind randomized placebo-controlled pilot study of neuropsychiatric adverse events in abstinent smokers treated with varenicline or placebo. Biol Psychiatry. 2011;69:1075-82 pubmed publisher
    ..There have been spontaneous postmarketing reports of neuropsychiatric adverse events (NPAEs) in smokers without a history of psychiatric illness quitting with varenicline...
  31. Alimohammadi I, Sandrock S, Gohari M. The effects of low frequency noise on mental performance and annoyance. Environ Monit Assess. 2013;185:7043-51 pubmed publisher
    ..05). This research showed that neuroticism does not influence mental performance. It seems that LFN has increased arousal level of participants, and extraversion has a considerable impact on mental performance. ..
  32. Poromaa I, Segebladh B. Adverse mood symptoms with oral contraceptives. Acta Obstet Gynecol Scand. 2012;91:420-7 pubmed publisher
    ..Available data suggest that lower doses of ethinylestradiol could be beneficial. ..
  33. von Heydrich L, Schiamberg L, Chee G. Social-relational risk factors for predicting elder physical abuse: an ecological bi-focal model. Int J Aging Hum Dev. 2012;75:71-94 pubmed
  34. Karamitros G, Kitsos N, Athanasopoulos F. A case of enterobiasis presenting as post-traumatic-stress-disorder (PTSD): a curious case of the infection with predominant mental health symptoms, presenting for the first time in the settings of a refugee camp. Pan Afr Med J. 2017;27:111 pubmed publisher
    ..This infection is the first documented case of enterobiasis in the settings of a refugee camp and can highlight the unsanitary living conditions that refugees have to endure in those camps. ..
  35. Uzun S, Kozumplik O. Reinforcement of irritability during therapy with benzodiazepines. Psychiatr Danub. 2011;23:129-30 pubmed
    ..It is necessary to warn patients who take benzodiazepines in therapy that reinforcement of irritability may occur in case of higher dosage of benzodiazepines, which may be misinterpreted as worsening in mental condition. ..
  36. Fava G, Fabbri S, Sirri L, Wise T. Psychological factors affecting medical condition: a new proposal for DSM-V. Psychosomatics. 2007;48:103-11 pubmed
    ..literature: disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, and irritable mood. These syndromes, in addition to the DSM definition of hypochondriasis, can yield clinical specification in ..
  37. Kayatekin Z, Sabo A, Halbreich U. Levetiracetam for treatment of premenstrual dysphoric disorder: a pilot, open-label study. Arch Womens Ment Health. 2008;11:207-11 pubmed publisher
    ..Anticonvulsant medications, specifically levetiracetam, could be effective in the treatment of PMDD. Future double-blind, placebo controlled, randomized studies are warranted and should include larger number of patients. ..
  38. Marcus R, Owen R, Kamen L, Manos G, McQuade R, Carson W, et al. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. J Am Acad Child Adolesc Psychiatry. 2009;48:1110-9 pubmed publisher
    ..3 kg, and 15 mg/day +1.5 kg; all p < .05 versus placebo. Aripiprazole was efficacious and generally safe and well tolerated in the treatment of children and adolescents with irritability associated with autistic disorder. ..
  39. Quitadamo P, Buonavolontà R, Miele E, Masi P, Coccorullo P, Staiano A. Total and abdominal obesity are risk factors for gastroesophageal reflux symptoms in children. J Pediatr Gastroenterol Nutr. 2012;55:72-5 pubmed publisher
    ..The risk of GERD symptoms rises progressively with the increase in both body mass index and waist circumference, even in normal-weight children. ..
  40. Ghaleiha A, Mohammadi E, Mohammadi M, Farokhnia M, Modabbernia A, Yekehtaz H, et al. Riluzole as an adjunctive therapy to risperidone for the treatment of irritability in children with autistic disorder: a double-blind, placebo-controlled, randomized trial. Paediatr Drugs. 2013;15:505-14 pubmed publisher
    ..Riluzole add-on therapy shows several therapeutic outcomes, particularly for improving irritability, in children with autism. However, its add-on to risperidone also results in significantly increased appetite and weight gain. ..
  41. Gay C. [Bipolar and other affective disorders]. Encephale. 2008;34 Suppl 4:S130-7 pubmed publisher
  42. Maremmani I, Pacini M, Popovic D, Romano A, Maremmani A, Perugi G, et al. Affective temperaments in heroin addiction. J Affect Disord. 2009;117:186-92 pubmed publisher
    ..Much of the literature has described personality disorder constructs for heroin addicts. Building on previous work we examine the relevance of affective temperament measures in these patients...
  43. Pawlaczyk Luszczynska M, Dudarewicz A, Szymczak W, Sliwinska Kowalska M. Evaluation of annoyance from low frequency noise under laboratory conditions. Noise Health. 2010;12:166-81 pubmed publisher
    ..Generally, over half of the subjects were predicted to be highly annoyed by LFN at the low frequency A-weighted SPL or C-weighted SPL above 62 and 83 dB, respectively. ..
  44. Dennerstein L, Lehert P, Heinemann K. Global study of women's experiences of premenstrual symptoms and their effects on daily life. Menopause Int. 2011;17:88-95 pubmed publisher
    ..To determine cross-cultural and other effects on women's experiences of premenstrual symptoms and their impact on activities of daily life (ADL)...
  45. Charland L. Alexander Crichton on the psychopathology of the passions. Hist Psychiatry. 2008;19:275-96 pubmed
  46. Moilanen J, Mikkola T, Raitanen J, Heinonen R, Tomas E, Nygård C, et al. Effect of aerobic training on menopausal symptoms--a randomized controlled trial. Menopause. 2012;19:691-6 pubmed publisher
    ..The aim of this study was to assess whether aerobic training affects menopausal symptoms in recently postmenopausal sedentary women...
  47. Johansson A, Nikamo P, Schalling M, Landen M. AKR1C4 gene variant associated with low euthymic serum progesterone and a history of mood irritability in males with bipolar disorder. J Affect Disord. 2011;133:346-51 pubmed publisher
    b>Irritable mood during mood elevation is common in bipolar disorder. The progesterone metabolite allopregnanolone (ALLO) has been implicated in other disorders presenting with irritability...
  48. Stigler K, Diener J, Kohn A, Li L, Erickson C, Posey D, et al. Aripiprazole in pervasive developmental disorder not otherwise specified and Asperger's disorder: a 14-week, prospective, open-label study. J Child Adolesc Psychopharmacol. 2009;19:265-74 pubmed publisher
    ..Larger-scale placebo-controlled studies are needed to elucidate the efficacy and tolerability of aripiprazole in this understudied population. ..
  49. Ostling S, Gustafson D, Waern M. Psychotic and behavioural symptoms in a population-based sample of the very elderly subjects. Acta Psychiatr Scand. 2009;120:147-52 pubmed publisher
    ..Since these symptoms lead to decreased ability to function in daily life and increased caregiver burden, it is important for health professionals to identify and treat these symptoms also in non-demented. ..
  50. Hollander E, Chaplin W, Soorya L, Wasserman S, Novotny S, Rusoff J, et al. Divalproex sodium vs placebo for the treatment of irritability in children and adolescents with autism spectrum disorders. Neuropsychopharmacology. 2010;35:990-8 pubmed publisher
    ..This study suggests the efficacy of divalproex for the treatment of irritability in children and adolescents with ASD. Larger sample follow-up studies are warranted. ..
  51. Seidel A, Prinz J. Sound morality: irritating and icky noises amplify judgments in divergent moral domains. Cognition. 2013;127:1-5 pubmed publisher
    ..As compared to disgust and control condition, anger increases severity of judgments about crimes against persons, and disgust increases severity of judgments about crimes against nature, but not conversely. ..
  52. Anderson D, Maye M, Lord C. Changes in maladaptive behaviors from midchildhood to young adulthood in autism spectrum disorder. Am J Intellect Dev Disabil. 2011;116:381-97 pubmed publisher
    ..Compared with youths without autism spectrum disorder, children with the disorder showed greater heterogeneity in trajectories for maladaptive behaviors. ..
  53. Posey D, Wiegand R, Wilkerson J, Maynard M, Stigler K, McDougle C. Open-label atomoxetine for attention-deficit/ hyperactivity disorder symptoms associated with high-functioning pervasive developmental disorders. J Child Adolesc Psychopharmacol. 2006;16:599-610 pubmed
    ..Weight decreased by a mean of 0.8 kg during the 8-week trial. Placebo-controlled studies are indicated to determine atomoxetine's efficacy for ADHD symptoms in PDDs. ..