title: The cross-national epidemiology of DSM-IV intermittent explosive disorder.
abstract: This is the first cross-national study of intermittent explosive disorder (IED).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors: Department of Psychological Medicine,University of Otago,PO Box 56,Dunedin 9054,New Zealand.
authors: K M
authors: KM
authors: Scott
authors: Department of Psychological Medicine,University of Otago,PO Box 56,Dunedin 9054,New Zealand.
authors: C C W
authors: CC
authors: Lim
authors: Department of Health Care Policy,Harvard University Medical School,180 Longwood Avenue,Boston,MA 02115,USA.
authors: I
authors: I
authors: Hwang
authors: Medical University of Wroclaw,L. Pasteur Str. 10,50-367 Wroclaw,Poland.
authors: T
authors: T
authors: Adamowski
authors: Department of Psychiatry,College of Medicine,Qadisia University,Diwaniya 00964,Iraq.
authors: A
authors: A
authors: Al-Hamzawi
authors: Department of Psychiatry,State University of New York at Stony Brook,Putnam Hall - South Campus,Stony Brook,NY 11794-8790,USA.
authors: E
authors: E
authors: Bromet
authors: University of Ulster,College Avenue,Londonderry BT48 7JL,UK.
authors: B
authors: B
authors: Bunting
authors: Universidad Peruana Cayetano Heredia,Facultad de Salud Pública y Administración,Honorio Delgado,Lima,Peru.
authors: M P
authors: MP
authors: Ferrand
authors: Health Services and Research Evaluation Center,National School of Public Health Management and Professional Development,31 Vaselor Street,Bucharest,021253,Romania.
authors: S
authors: S
authors: Florescu
authors: Department of Psychiatry,University College Hospital,PMB 5116,Ibadan,Nigeria.
authors: O
authors: O
authors: Gureje
authors: National Center for Public Health Protection,15 Acad. Ivan Ev. Geshov blvd,1431 Sofia,Bulgaria.
authors: H
authors: H
authors: Hinkov
authors: 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.
authors: C
authors: C
authors: Hu
authors: 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.
authors: E
authors: E
authors: Karam
authors: Department of Psychiatry,The Chinese University of Hong Kong,Flat 7A, Block E,Staff Quarters,Prince of Wales Hospital,Shatin,Hong Kong SAR.
authors: S
authors: S
authors: Lee
authors: Universidad Colegio Mayor de Cundinamarca,Cra 7 No. 119-14 Cons. 511,Bogotá D.C.,Colombia.
authors: J
authors: J
authors: Posada-Villa
authors: Department of Psychiatry and Mental Health,University of Cape Town,Private Bag X3, Rondebosch 7701,Cape Town,South Africa.
authors: D
authors: D
authors: Stein
authors: National Institute of Mental Health,National Center of Neurology and Psychiatry,4-1-1 Ogawa-Higashi,Kodaira,Tokyo 187-8553,Japan.
authors: H
authors: H
authors: Tachimori
authors: Department of Social Medicine,Federal University of Espírito Santo (UFES),Rua Dr Eurico de Aguiar 888/705,Vitoria,ES 29055-280,Brazil.
authors: M C
authors: MC
authors: Viana
authors: 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.
authors: M
authors: M
authors: Xavier
authors: Department of Health Care Policy,Harvard University Medical School,180 Longwood Avenue,Boston,MA 02115,USA.
authors: R C
authors: RC
authors: Kessler
mesh_terms: D000293:Adolescent; D000349:Africa / Q000453:epidemiology; D017668:Age of Onset; D000437:Alcoholism / Q000453:epidemiology*; D001208:Asia / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008877:Middle East / Q000453:epidemiology; D015995:Prevalence; D000067073:Psychological Trauma / Q000453:epidemiology*; D012307:Risk Factors; D012742:Sex Offenses / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Cross-national studies; DSM-IV; World Mental Health Surveys; epidemiology; intermittent explosive disorder