Psych News Alert: Most Patients With IED Have Comorbid Psychiatric Diagnoses, Study Finds

Nearly 96% of patients with intermittent explosive disorder (IED) have at least one additional psychiatric diagnosis, according to a study issued yesterday in JAMA Psychiatry.

IED is typically diagnosed when patients have clinically significant, impulsive aggressive behavior that is not better explained by another condition, such as bipolar disorder, borderline personality disorder, intoxication, or withdrawal from substances, wrote Yanli Zhang-James, M.D., Ph.D., of SUNY Upstate Medical University, and colleagues.

Using data from the TriNetX Research Network, which includes records from 117.7 million patients from 87 health care systems, Zhang-James and colleagues identified 33,410 individuals who had at least one diagnostic record of IED—just 0.03% of patients in the network. The researchers successfully matched 30,357 of these patients with demographically similar individuals who did not have IED.

Patients with IED had extensive medical comorbidities, and only 4.3% did not have another psychiatric diagnosis. Additional findings include:

• Patients with IED were on average 12 years younger at their first health care visit compared with those without IED and were more likely to be male, White, and non-Hispanic. They also had more health care encounters and a longer history of medical records.
• Patients with IED had a substantially higher risk for all psychiatric diseases compared with those without IED. For example, patients with IED were nearly 20 times as likely to have an intellectual disability and 76 times as likely to have a disorder of adult personality and behavior. They were also much more likely to have schizoaffective disorders.
• Among neurological conditions, patients with IED had the highest risk for neurodegenerative diseases, followed by movement disorders, cerebral palsy, and sleep disorders.

The authors noted that other epidemiological studies of IED have reported a prevalence that is much higher than 0.03%. They suggested that clinicians “should consider applying the diagnosis of IED more frequently when warranted.

“Highlighting aggression as a separate diagnosis may focus more attention on aggressive behavior and facilitate the development of targeted treatments. Otherwise, aggressive behavior remains somewhat hidden as a feature within other disorders,” they wrote.

For related information, see the Psychiatric News alert “History of Anger Attacks May Point to Soldiers at Greatest Risk of Anxiety Disorder, Suicidal Ideation.”

(Image: Getty Images/iStock/Antony Robinson)

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