A family history study of intermittent explosive disorder
ABSTRACT Intermittent Explosive Disorder (IED) is newly appreciated as a commonly occurring disorder of impulsive aggression. Since aggression and impulsivity are under genetic influence, IED may be familial.
Blinded and controlled family history study of IED and co-morbid conditions in an outpatient clinical research center for impulsive aggression. The subjects were first-degree relatives of individuals who did and did not meet criteria for IED by DSM-IV and Research Criteria.
Elevated Morbid Risk of IED was observed in relatives of IED Probands compared with relatives of Non-IED Probands. This familial signal of IED was not affected by comorbidity in the IED Probands of comorbidity in the relatives of the IED Probands.
IED, as defined by research criteria, appears to be familial and may not be an artifact of other co-morbid conditions.
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ABSTRACT: Impulse control disorders (ICDs) are characterized by urges and behaviors that are excessive and/or harmful to oneself or others and cause significant impairment in social and occupational functioning, as well as legal and financial difficulties. ICDs are relatively common psychiatric conditions, yet are poorly understood by the general public, clinicians, and individuals struggling with the disorder. Although ICD treatment research is limited, studies have shown ICDs may respond well to pharmacological treatment. This article presents a brief overview about the clinical characteristics of ICDs and pharmacological treatment options for individuals with ICDs.Frontiers in Psychiatry 02/2011; 2:1. DOI:10.3389/fpsyt.2011.00001
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ABSTRACT: A disorder of impulsive aggression has been included in DSM since the first edition. In DSM-III, this disorder was codified as intermittent explosive disorder, and it was thought to be rare. However, the diagnostic criteria for the disorder were poorly operationalized, and empirical research was limited until research criteria were developed a decade ago. Subsequently, renewed interest in disorders of impulsive aggression led to a recent series of community-based studies that have documented intermittent explosive disorder to be as common as many other psychiatric disorders. Other recent research indicates that compared with DSM-IV criteria for intermittent explosive disorder, research criteria for the disorder better identify individuals with elevated levels of aggression, impulsivity, familial risk of aggression, and abnormalities in neurobiological markers of aggression. In addition, other data strongly suggest important delimitation from other disorders previously thought to obscure the diagnostic uniqueness of intermittent explosive disorder. Overall, these data suggest that the diagnostic validity for the integrated research criteria is substantial and is now sufficient for recognition and inclusion in DSM-5.American Journal of Psychiatry 04/2012; 169(6):577-88. DOI:10.1176/appi.ajp.2012.11081259 · 13.56 Impact Factor
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ABSTRACT: CONTEXT Epidemiologic studies of adults show that DSM-IV intermittent explosive disorder (IED) is a highly prevalent and seriously impairing disorder. Although retrospective reports in these studies suggest that IED typically begins in childhood, no previous epidemiologic research has directly examined the prevalence or correlates of IED among youth. OBJECTIVE To present epidemiologic data on the prevalence and correlates of IED among US adolescents in the National Comorbidity Survey Replication Adolescent Supplement. DESIGN United States survey of adolescent (age, 13-17 years) DSM-IV anxiety, mood, behavior, and substance disorders. SETTING Dual-frame household-school samples. PARTICIPANTS A total of 6483 adolescents (interviews) and parents (questionnaires). MAIN OUTCOME MEASURES The DSM-IV disorders were assessed with the World Health Organization Composite International Diagnostic Interview (CIDI). RESULTS Nearly two-thirds of adolescents (63.3%) reported lifetime anger attacks that involved destroying property, threatening violence, or engaging in violence. Of these, 7.8% met DSM-IV/CIDI criteria for lifetime IED. Intermittent explosive disorder had an early age at onset (mean age, 12.0 years) and was highly persistent, as indicated by 80.1% of lifetime cases (6.2% of all respondents) meeting 12-month criteria for IED. Injuries related to IED requiring medical attention reportedly occurred 52.5 times per 100 lifetime cases. In addition, IED was significantly comorbid with a wide range of DSM-IV/CIDI mood, anxiety, and substance disorders, with 63.9% of lifetime cases meeting criteria for another such disorder. Although more than one-third (37.8%) of adolescents with 12-month IED received treatment for emotional problems in the year before the interview, only 6.5% of respondents with 12-month IED were treated specifically for anger. CONCLUSIONS Intermittent explosive disorder is a highly prevalent, persistent, and seriously impairing adolescent mental disorder that is both understudied and undertreated. Research is needed to uncover risk and protective factors for the disorder, develop strategies for screening and early detection, and identify effective treatments.Archives of general psychiatry 07/2012; DOI:10.1001/archgenpsychiatry.2012.592 · 13.75 Impact Factor