A cohort study examined comorbidities between intermittent explosive disorder and other conditions in 30,357 patients with IED compared to 30,357 matched controls.

The research, led by Yanli Zhang-James, M.D., Ph.D., from SUNY Upstate Medical University, analyzed electronic medical records from the TriNetX Research Network over a mean follow-up time of 4.8 years.

The study found that 95.7% of individuals with intermittent explosive disorder (IED) had at least one additional psychiatric diagnosis. IED was associated with various psychiatric diagnoses, including substance use disorder and disorders of adult personality and behavior. The data showed 38% of IED patients had ADHD diagnoses.

Neurological conditions significantly associated with IED included neurodegenerative diseases, epilepsy, movement disorders, and cerebral palsy.

The study, published in JAMA Psychiatry, identified higher rates of somatic conditions among IED patients, including obesity (HR, 1.6; 95% CI, 1.5-1.7), hyperlipidemia, hypertension, and gastroesophageal reflux disease.

"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," said Dr. Zhang-James.

The prevalence of IED in the study population was 0.03%, compared to 7.3% lifetime prevalence previously reported in the US National Comorbidity Replication Study.

The authors noted that reliance on electronic medical records and low diagnostic rates of IED affect the generalizability of these findings. They called for further prospective studies for validation.

Full disclosures can be found in the study.