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The cross-national epidemiology of DSM-IV intermittent explosive disorder

Published online by Cambridge University Press:  30 August 2016

K. M. Scott ,
C. C. W. Lim ,
I. Hwang ,
T. Adamowski ,
A. Al-Hamzawi ,
E. Bromet ,
B. Bunting ,
M. P. Ferrand ,
S. Florescu  and
O. Gureje
...Show all authors
K. M. Scott*
Affiliation:
Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
C. C. W. Lim
Affiliation:
Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
I. Hwang
Affiliation:
Department of Health Care Policy, Harvard University Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
T. Adamowski
Affiliation:
Medical University of Wroclaw, L. Pasteur Str. 10, 50-367 Wroclaw, Poland
A. Al-Hamzawi
Affiliation:
Department of Psychiatry, College of Medicine, Qadisia University, Diwaniya 00964, Iraq
E. Bromet
Affiliation:
Department of Psychiatry, State University of New York at Stony Brook, Putnam Hall – South Campus, Stony Brook, NY 11794-8790, USA
B. Bunting
Affiliation:
University of Ulster,College Avenue, Londonderry BT48 7JL, UK
M. P. Ferrand
Affiliation:
Universidad Peruana Cayetano Heredia, Facultad de Salud Pública y Administración, Honorio Delgado, Lima, Peru
S. Florescu
Affiliation:
Health Services and Research Evaluation Center, National School of Public Health Management and Professional Development, 31 Vaselor Street, Bucharest, 021253, Romania
O. Gureje
Affiliation:
Department of Psychiatry, University College Hospital, PMB 5116, Ibadan, Nigeria
H. Hinkov
Affiliation:
National Center for Public Health Protection, 15 Acad. Ivan Ev. Geshov blvd, 1431 Sofia, Bulgaria
C. Hu
Affiliation:
Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, 13-15/F, Block B, No. 2019 Buxin Road, Luohu District, No. 1080 Cuizu Road, Luohu District, 518020, Guangdong Province, People's Republic of China
E. Karam
Affiliation:
St. George Hospital University Medical Center, Balamand University, Faculty of Medicine, Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Medical Institute for Neuropsychological Disorders (MIND), Beirut, Lebanon Department of Psychiatry and Clinical Psychology, Institute for Development, Research Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Ashrafieh 166378, Lebanon
S. Lee
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Flat 7A, Block E, Staff Quarters, Prince of Wales Hospital, Shatin, Hong Kong SAR
J. Posada-Villa
Affiliation:
Universidad Colegio Mayor de Cundinamarca, Cra 7 No. 119-14 Cons. 511, Bogotá D.C., Colombia
D. Stein
Affiliation:
Department of Psychiatry and Mental Health, University of Cape Town, Private Bag X3, Rondebosch 7701, Cape Town, South Africa
H. Tachimori
Affiliation:
National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
M. C. Viana
Affiliation:
Department of Social Medicine, Federal University of Espírito Santo (UFES), Rua Dr Eurico de Aguiar 888/705, Vitoria, ES 29055-280, Brazil
M. Xavier
Affiliation:
Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard University Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
*
*Address for correspondence: K. M. Scott, Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand. (Email: kate.scott@otago.ac.nz)
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Abstract

Background

This is the first cross-national study of intermittent explosive disorder (IED).

Method

A total of 17 face-to-face cross-sectional household surveys of adults were conducted in 16 countries (n = 88 063) as part of the World Mental Health Surveys initiative. The World Health Organization Composite International Diagnostic Interview (CIDI 3.0) assessed DSM-IV IED, using a conservative definition.

Results

Lifetime prevalence of IED ranged across countries from 0.1 to 2.7% with a weighted average of 0.8%; 0.4 and 0.3% met criteria for 12-month and 30-day prevalence, respectively. Sociodemographic correlates of lifetime risk of IED were being male, young, unemployed, divorced or separated, and having less education. The median age of onset of IED was 17 years with an interquartile range across countries of 13–23 years. The vast majority (81.7%) of those with lifetime IED met criteria for at least one other lifetime disorder; co-morbidity was highest with alcohol abuse and depression. Of those with 12-month IED, 39% reported severe impairment in at least one domain, most commonly social or relationship functioning. Prior traumatic experiences involving physical (non-combat) or sexual violence were associated with increased risk of IED onset.

Conclusions

Conservatively defined, IED is a low prevalence disorder but this belies the true societal costs of IED in terms of the effects of explosive anger attacks on families and relationships. IED is more common among males, the young, the socially disadvantaged and among those with prior exposure to violence, especially in childhood.

Keywords

Cross-national studiesDSM-IVepidemiologyintermittent explosive disorderWorld Mental Health Surveys
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 15 , November 2016 , pp. 3161 - 3172
Copyright
Copyright © Cambridge University Press 2016 

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