Informant, Sex, and Age Correlates of Irritability in the Mental Health of Children and Young People Survey 2017 in England

Background: While irritability is one of the most common problems for which families seek mental health treatment for children, it is still unclear how factors such as age, sex, and reporting source influence the prevalence of and impairment due to irritability in youth in the population. Methods: Using data from Mental Health of Children and Young People Survey 2017 in England we examined the prevalence of irritable mood and temper outbursts in 6,881 children aged 5-17 using parent report (49.8% females) and in 2,904 children aged 11-17 for self-report (50.7% females). Informaiton on irritability was collected with the disruptive mood dysregulation disorder (DMDD) section of the Development and Well-Being Assessment (DAWBA). We also examined associations with mental health difficulties and impairment (SDQ) as well as psychiatric disorders (DAWBA). Results: Parents reported higher levels of irritability in males (20-25%) compared to females during childhood (15-19%), but this difference disappeared in adolescence. On the other hand, adolescent females reported more irritable mood in themselves (29%) compared to adolescent males (23%). This self-reported irritability in adolescent females was associated with greater emotional problems (b=0.28, SE=0.10, p=0.004) and overall impairment (irritable mood, b=0.29, SE=0.09, p=0.001; temper outbursts: b=0.28, SE=0.08, p<0.001) compared to males. The presence of irritability in females was also associated with a higher relative increase of psychiatric disorders, particularly those of externalizing nature (b=0.53, SE=0.15, p=0.001)Conclusions: Age, sex, informant, and their interactions are sources of heterogeneity in irritability reporting. These results highlight the importance of considering the perspectives of adolescents, and females sin particular, when assessing irritability in young people, since we might otherwise miss information on experiences of affect that might not be observable by external informants. Future studies should clarify whether gender biases exist in parent-reported irritability and its correlates.