Psychosocial impairment in DSM-5 intermittent explosive disorder

Abstract

The purpose of this study was to document the functional severity of DSM-5 IED in a clinical research sample. IED and control groups were compared on psychosocial functioning, life satisfaction, and on a variety of cognitive and behavioral issues. IED study participants reported significantly worse psychosocial function, quality of life, and higher job dysfunction than both psychiatric and healthy control study participants. The presence of DSM-5 IED is associated with significant psychosocial and functional impairment. Early intervention may aid in minimizing the consequences of impulsive aggressive behavior, and improving psychosocial functioning and quality of life.

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

“…Coccaro et al who have led the clinical research on IED, have conducted a series of studies in which participants responding to advertisements seeking individuals with anger difficulties were diagnosed with DSM-5 IED, other mental disorders, or no disorders. In these studies, the IED group reported greater functional impairment than the ‘other mental disorder’ comparison group (Kulper et al ., 2015; Rynar and Coccaro, 2018), whereas our finding of 39.8% of those with IED reporting severe impairment is lower than the corresponding proportion reported for other mental disorders (Scott et al ., 2018). In these and in other clinical studies from the same group (Fahlgren et al ., 2019; Fanning et al ., 2019), IED-associated comorbidity was dominated by internalising disorders, in contrast to our finding that comorbidity was at least equally if not more likely to be with externalising disorders.…”

“…reported greater functional impairment than the 'other mental disorder' comparison group (Kulper et al, 2015;Rynar and Coccaro, 2018), whereas our finding of 39.8% of those with IED reporting severe impairment is lower than the corresponding proportion reported for other mental disorders (Scott et al, 2018). In these and in other clinical studies from the same group (Fahlgren et al, 2019;Fanning et al, 2019), IED-associated comorbidity was dominated by internalising disorders, in contrast to our finding that comorbidity was at least equally if not more likely to be with externalising disorders.…”

“…Some researchers have chosen to deal with the difficulty of differentiating between IED and bipolar disorder by excluding people with a lifetime history of bipolar disorder from the IED sample (Kulper et al ., 2015; Rynar and Coccaro, 2018; Fahlgren et al ., 2019). It is unclear why the same theoretical concern does not apply to some of the other comorbid disorders, and if we were to remove all those with lifetime comorbidities associated with impulsive aggression from the group classified with IED we would end up with a much smaller group.…”

“…As previously reported (Scott et al, 2016), a small proportion of the IED sample admitted to purposely torturing or injuring an animal, or arson, within the prior 12 months, so it is possible that these individuals may be more appropriately classified as personality disordered (or CD) than IED. Some researchers have chosen to deal with the difficulty of differentiating between IED and bipolar disorder by excluding people with a lifetime history of bipolar disorder from the IED sample (Kulper et al, 2015;Rynar and Coccaro, 2018;Fahlgren et al, 2019). It is unclear why the same theoretical concern does not apply to some of the other comorbid disorders, and if we were to remove all those with lifetime comorbidities associated with impulsive aggression from the group classified with IED we would end up with a much smaller group.…”

Zebrafish models of impulsivity and impulse control disorders

“…Intermittent explosive disorder is characterized by recurrent episodes of aggression (both verbal and physical) with destructive behavioral outbursts (American Psychiatric Association, 2013; Oliver et al., 2016), psychosocial deficits (Rynar & Coccaro, 2018) and comorbid substance abuse, mood and anxiety disorders (Coccaro et al., 2016; Kessler et al., 2006). APD is another serious ICD categorized as a pervasive pattern of disregard for, and violation of, the rights of others, occurring during or after the adolescence (American Psychiatric Association, 2013).…”