Department of Economics and Business Economics

Intermittent explosive disorder subtypes in the general population: Association with comorbidity, impairment and suicidality

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • K. M. Scott, University of Otago
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  • Y. A. De Vries, University of Groningen
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  • S. Aguilar-Gaxiola, University of California at Davis
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  • A. Al-Hamzawi, University of Al-Qadisiya
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  • J. Alonso, Pompeu Fabra University, CIBER Epidemiology and Public Health CIBERESP, Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Catalonia, Spain.
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  • E. J. Bromet, Stony Brook University
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  • B. Bunting, Ulster University
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  • J. M. Caldas-De-Almeida, NOVA University Lisbon
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  • A. Ciá, Anxiety Disorders Center
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  • S. Florescu, National School of Public Health Management and Professional Development
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  • O. Gureje, University of Ibadan
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  • C. Y. Hu, Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital
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  • E. G. Karam, University of Balamand, Saint George Hospital University Medical Center, Institute for Development Research Advocacy and Applied Care (IDRAAC)
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  • A. Karam, Institute for Development Research Advocacy and Applied Care (IDRAAC)
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  • N. Kawakami, University of Tokyo
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  • R. C. Kessler, Harvard Medical School
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  • S. Lee, Chinese University of Hong Kong
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  • J. McGrath
  • B. Oladeji, University of Ibadan
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  • J. Posada-Villa, Universidad Colegio Mayor de Cundinamarca
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  • D. J. Stein, University of Cape Town
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  • Z. Zarkov, National Center of Public Health and Analyses
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  • P. De Jonge, University of Groningen

AimsIntermittent explosive disorder (IED) is characterised by impulsive anger attacks that vary greatly across individuals in severity and consequence. Understanding IED subtypes has been limited by lack of large, general population datasets including assessment of IED. Using the 17-country World Mental Health surveys dataset, this study examined whether behavioural subtypes of IED are associated with differing patterns of comorbidity, suicidality and functional impairment.MethodsIED was assessed using the Composite International Diagnostic Interview in the World Mental Health surveys (n = 45 266). Five behavioural subtypes were created based on type of anger attack. Logistic regression assessed association of these subtypes with lifetime comorbidity, lifetime suicidality and 12-month functional impairment.ResultsThe lifetime prevalence of IED in all countries was 0.8% (s.e.: 0.0). The two subtypes involving anger attacks that harmed people ('hurt people only' and 'destroy property and hurt people'), collectively comprising 73% of those with IED, were characterised by high rates of externalising comorbid disorders. The remaining three subtypes involving anger attacks that destroyed property only, destroyed property and threatened people, and threatened people only, were characterised by higher rates of internalising than externalising comorbid disorders. Suicidal behaviour did not vary across the five behavioural subtypes but was higher among those with (v. those without) comorbid disorders, and among those who perpetrated more violent assaults.ConclusionsThe most common IED behavioural subtypes in these general population samples are associated with high rates of externalising disorders. This contrasts with the findings from clinical studies of IED, which observe a preponderance of internalising disorder comorbidity. This disparity in findings across population and clinical studies, together with the marked heterogeneity that characterises the diagnostic entity of IED, suggests that it is a disorder that requires much greater research.

Original languageEnglish
Article numbere138
JournalEpidemiology and Psychiatric Sciences
Volume29
Number of pages10
ISSN2045-7960
DOIs
Publication statusPublished - Jun 2020

    Research areas

  • Comorbidity, impairment, Intermittent Explosive Disorder, suicidality, World Mental Health Surveys

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