Up to 16 Million U.S. Adults May Have Ever Had 'Intermittent Explosive Disorder'
By Miranda Hitti
WebMD Medical News
Latest MedicineNet News
Reviewed By Louise Chang, MD
on Monday, June 05, 2006
June 5, 2006 -- A rage disorder called intermittent explosive disorder may be more common in the U.S. than previously thought.
As many as 16 million American adults may have had the disorder at some point, depending on how it is defined, according to a study published in the Archives of General Psychiatry.
The study's researchers included Ronald Kessler, PhD, of Harvard Medical School's department of health care policy. A previous study -- done in 2004 by other experts -- showed a lifetime prevalence of 4% for the condition.
“Intermittent explosive disorder is a much more common condition than previously recognized,” write Kessler and colleagues.
The disorder typically starts at age 14 and is often followed by other mental health problems, the researchers note. They call for early detection, outreach, and treatment -- possibly starting in schools.
Kessler's study is based on in-person interviews with 9,282 adults, done for a 2001-2003 national survey.
With intermittent explosive disorder, Kessler's team wasn't talking about normal feelings of anger. Those suffering from the disorder reacted with an anger grossly out of proportion to the situation triggering it, they note.
They defined the condition as involving at least three incidents over a lifetime of anger attacks in which physical harm was done to other people or to property.
To qualify as intermittent explosive disorder, those attacks must not have been linked to drugs, alcohol, or conditions such as depression.
Survey questions included how often participants had experienced anger attacks in which they:
- Lost control and broke or smashed something worth more than a few dollars
- Lost control and hit or tried to hurt someone
- Lost control and threatened to hit or hurt someone
The survey presents a snapshot of the prevalence of the rage disorder. It doesn't show whether the condition has become more common over time.
Kessler's team reports that between 5.4% and 7.3% of survey participants had had intermittent explosive disorder at some point in their life. Those percentages translate into 11.5 million to 16 million lifetime cases nationwide.
Fewer of those surveyed -- between 2.7% and 3.9% -- had had intermittent explosive disorder in the previous year. Those figures represent 5.9 million to 8.5 million cases in a year's time, note Kessler and colleagues.
The disorder typically started when sufferers were about 14 years old, according to the recollections of survey participants, who were all at least 18 at the time of the survey.
Researchers found “modest” patterns for other social and economic factors. Intermittent explosive disorder was relatively rare in people aged 60 and older. It was more common among men, young adults, workers with low incomes and low educations, and married people who weren't homemakers.
Intermittent explosive disorder “is very widely distributed in the population rather than being concentrated in any one segment of society,” the researchers write.
Rage Rarely Treated?
Most people with the rage disorder -- about 60% -- eventually got professional treatment for emotional or substance abuse problems, the study shows.
That finding may mean that intermittent explosive disorder eventually leads to other mental illnesses or substance abuse.
The survey also shows that fewer than three in 10 participants with intermittent explosive disorder had ever received treatment for their anger, the researchers note.
Intermittent explosive disorder may be a “promising target for early detection, outreach, and treatment,” write Kessler and colleagues. They add that, given the condition's early start, “early detection might well be an important addition to ongoing school-based violence prevention programs.”
The journal notes that the study was funded in part by the drug companies Eli Lilly and Company, GlaxoSmithKline, Bristol-Myers Squibb, and Ortho-McNeil Pharmaceutical Inc.
SOURCES: Kessler, R. Archives of General Psychiatry, June 2006; vol 63: pp 669-678. News release, National Institute of Mental Health, National Institutes of Health. News release, Harvard Medical School.
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