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

Aims. Intermittent 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...

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Published: 2020
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LEADER 00000njm a2000000a 4500
001 oai:repository.ui.edu.ng:123456789/13626
042 |a dc 
720 |a Scott, K. M.  |e author 
720 |a de Vries, Y. A.  |e author 
720 |a Aguilar-Gaxiola, S.  |e author 
720 |a Al-Hamzawi, A.  |e author 
720 |a Alonso, J.  |e author 
720 |a Bromet, E. J.  |e author 
720 |a Bunting, B.  |e author 
720 |a Caldas-de-Almeida, J. M.  |e author 
720 |a Cía, A.  |e author 
720 |a Florescu, S.  |e author 
720 |a Gureje, O.  |e author 
720 |a Hu, C. Y.  |e author 
720 |a Karam, E. G.  |e author 
720 |a Karam, A.  |e author 
720 |a Kawakami, N.  |e author 
720 |a Kessler, R. C.  |e author 
720 |a Lee, S.  |e author 
720 |a McGrath, J.  |e author 
720 |a Oladeji, B.  |e author 
720 |a Posada-Villa, J.  |e author 
720 |a Stein, D. J.  |e author 
720 |a Zarkov, Z.  |e author 
720 |a de Jonge, P.  |e author 
260 |c 2020 
520 |a Aims. Intermittent 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. Methods. IED 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. Results. The 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 characterized 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. Conclusions. The 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 characterizes the diagnostic entity of IED, suggests that it is a disorder that requires much greater research. 
024 8 |a 2045-7960 
024 8 |a 2045-7979 
024 8 |a ui_art_scott_intermittent_2020 
024 8 |a Epidemiology and Psychiatric Sciences 29, e138 
024 8 |a https://repository.ui.edu.ng/handle/123456789/13626 
653 |a Comorbidity 
653 |a impairment 
653 |a Intermittent Explosive Disorder 
653 |a suicidality 
653 |a World Mental Health Surveys 
245 0 0 |a Intermittent explosive disorder subtypes in the general population: association with comorbidity, impairment and suicidality