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Psychiatric, Neurological, and Somatic Comorbidities in Intermittent Explosive Disorder

Y. Zhang-James, John Paliakkara, Joshua Schaeffer, J. Strayhorn, S. Faraone

JAMA psychiatry, 2025

30 participants · 8 citations

Abstract

Importance

Intermittent explosive disorder (IED) is an understudied psychiatric condition marked by impulsive aggression and poorly regulated emotional control, often resulting in interpersonal and societal consequences. Better understanding of comorbidities can improve screening, diagnosis, and treatment.

Objective

To investigate the prevalence of IED and its associations with psychiatric, neurological, and somatic disorders.

Design, Setting, and Participants

In this cohort study, matched groups of patients with and without IED were identified from the TriNetX Research Network (dated January 31, 2024). Electronic medical record data were analyzed. The mean (SD) time from the first to last known visits was 4.8 (5.4) years.

Exposure

Lifetime diagnosis of IED.

Main Outcomes and Measures

Main outcomes were International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnostic categories and root codes. Cox proportional hazard models were used to estimate and compare probabilities of acquiring other diagnoses. Key measures include the numbers and proportions of patients with these diagnoses and adjusted hazard ratios (HRs) for IED.

Results

Overall, 30 357 individuals with IED and 30 357 demographically matched controls were included. In each group, 21 313 (70%) were male, with a mean (SD) age at the first visit 26 (17) years. Despite only 0.03% of the total patient population having an IED diagnosis, extensive comorbidities with psychiatric,…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 30 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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