The prevalence and correlates of DSM-IV intermittent explosive disorder in the National Comorbidity Survey Replication.
BACKGROUND
Little is known about the epidemiology of intermittent explosive disorder (IED).


OBJECTIVE
To present nationally representative data on the prevalence and correlates of DSM-IV IED.


METHODS
The World Health Organization Composite International Diagnostic Interview was used to assess DSM-IV anxiety disorders, mood disorders, substance use disorders, and impulse control disorders.


METHODS
The National Comorbidity Survey Replication, a face-to-face household survey carried out in 2001-2003.


METHODS
A nationally representative sample of 9282 people 18 years and older.


METHODS
Diagnoses of DSM-IV IED.


RESULTS
Lifetime and 12-month prevalence estimates of DSM-IV IED were 7.3% and 3.9%, with a mean 43 lifetime attacks resulting in 1359 dollars in property damage. Intermittent explosive disorder-related injuries occurred 180 times per 100 lifetime cases. Mean age at onset was 14 years. Sociodemographic correlates were uniformly weak. Intermittent explosive disorder was significantly comorbid with most DSM-IV mood, anxiety, and substance disorders. Although the majority of people with IED (60.3%) obtained professional treatment for emotional or substance problems at some time in their life, only 28.8% ever received treatment for their anger, while only 11.7% of 12-month cases received treatment for their anger in the 12 months before interview.


CONCLUSIONS
Intermittent explosive disorder is a much more common condition than previously recognized. The early age at onset, significant associations with comorbid mental disorders that have later ages at onset, and low proportion of cases in treatment all make IED a promising target for early detection, outreach, and treatment.
Kessler
Ronald C
RC
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA. kessler@hcp.med.harvard.edu
Coccaro
Emil F
EF
Fava
Maurizio
M
Jaeger
Savina
S
Jin
Robert
R
Walters
Ellen
E
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000786:Anger; D015897:Comorbidity; D003415:Crime / Q000331:legislation & jurisprudence / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology