Multiple Complex Developmental Disorder (McDD)

Multiple Comlex Developmental Disorder (McDD) is recognized as a subtype of PDD-NOS in the Netherlands. It is an autism spectrum disorder in which people also suffer from emotion regulation problems and thought disorders. Its proposed criteria according to the Yale Child Study Center are as follows:


  1. Impaired social behavior/sensitivity, similar to that seen in autism, such as:

    • Social disinterest

    • Detachment, avoidance of others, or withdrawal

    • Impaired peer relations

    • Highly ambivalent attachments

    • Limited capacity for empathy or understanding what others are thinking or feeling


  2. Affective symptoms, including:

    • Impaired regulation of feelings

    • Intense, inappropriate anxiety

    • Recurrent panic

    • Emotional lability, without obvious cause


  3. Thought disorder symptoms, such as:

    • Sudden, irrational intrusions on normal thoughts

    • Magical thinking

    • Confusion between reality and fantasy

    • Delusions such as paranoid thoughts or fantasies of special power



In The Netherlands, slightly different criteria are used. For example, social disinhibition is proposed as a possible symptom in the social impairments category.

In the Dutch Wikipedia, McDD is referred to alternatively as juvenile schizophrenia and juvenile BPD. However, most parent-directed sources highlight the intense anxiety which is at the core of McDD. Psrenting, therefore, needs to be aimed at providing structure and boundaries and helping the child reduce their anxiety and emotional lability. Parents need to refrain from showing too much emotion to prevent the child from absorbing the parent’s emotions.

Children with McDD often experience psychotic symptons or full-blown psychosis in adolescence. The emotion regulation problems become less pronounced as individuals with McDD grow into adults, but social problems an thought diosorders often remain significant. Antipsychotic medications can be used to help reduce psychotic symptoms. Even so, most McDD individuals will need lifelong support.

I do not have a diagnosis of McDD, although I think I may meet its criteria. I remember my parents were asked about thought disorder symptoms and unprovoked emotional outbursts at my first autism assessment, but they said I didn’t have them. In reality, I had a lot of bizarre thoughts as a child and still do have them sometimes, and my parents were confused about the questions on unprovoked outbursts. I have, interestingly, foudn that antipsychotics help more with the emotion regulation problems than with the thought disorder symptoms. This does mean that I suffer in silence soometimes, because I do have strange fears and bizarre thoughts, but am too drugged up to act on them.

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2 thoughts on “Multiple Complex Developmental Disorder (McDD)

  1. My diagnosis of ASD at 52 years of age poses more questions than answers. I have a constant inner dialogue and arrange meetings with my self at night (talking out loud) to discuss philosophical matters etc. Nonsense speach, ‘clanging’ and neologisms are my life since about 7 yrs. Terrible impulsivity and boredom look like ADHD to my doctor at the Maudsley in London. I suppose I would have been diagnosed PDD-NOS before the umbrella term ‘ASD’.

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  2. Astrid
    Bizar thought occure With everyone. My daughter has been diagnosed With MCDD. Believe me, if you were to have McDD, the problems would be Very obvious to your parents. The impact on the child is severe. It is impossible to keep things inside. Maybe For a few hours or days but every child and adult with MCDD will become violent and loose controle of themselves. If you have Some of the signs you can have ASS, but not mcdd. For mcdd the symptoms would lite up like a Christmas tree and you wouldn’t fit in with the other ASS as some doesn’t qualify. Every human being can have some autistic symptoms but that as wel doesn’t qualify for having autism.

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