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Prevalence and psychiatric comorbidities of intermittent explosive disorders in Metropolitan São Paulo, Brazil

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Abstract

Purpose

To estimate the prevalence of intermittent explosive disorder (IED) in comorbidity with other psychiatric disorders and to describe the temporal sequencing of disorders in the São Paulo Metropolitan Area, Brazil.

Methods

Data from the São Paulo Megacity Mental Health Survey, a population-based study of 5037 adult individuals, were analyzed. The World Health Organization Composite International Diagnostic Interview (CID 3.0) was used to assess lifetime DSM-IV disorders, including IED, with a response rate of 81.3%.

Results

The majority (76.8%) of respondents with IED meet the criteria for at least one other psychiatric disorder, with a prevalence almost twice as high as that observed in individuals without IED. The prevalence of any anxiety, mood, impulse control or substance use disorders in respondents with IED was more than two times higher compared to those without IED, with prevalence ratios ranging from 2.1 (95% CI 1.74–2.48) to 2.9 (95% CI 2.12–4.06). The diagnosis of IED occurred earlier than most of the other mental disorders, except for those with usual onset in early childhood, as Specific and Social Phobias and Attention Deficit Disorder.

Conclusion

Considering that IED is a highly comorbid disorder and has an earlier onset than most other mental comorbidities in the Brazilian general population, these results may be useful in guiding governmental mental health actions.

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Acknowledgements

The São Paulo Megacity Mental Health Survey was supported by the State of São Paulo Research Foundation (FAPESP grant 03/00204-3). Instrument development was supported by Vitoria Foundation for Science and Technology (FACITEC grant 002/2003). The São Paulo Megacity Mental Health Survey is carried out in conjunction with the WHO-World Mental Health Survey Initiative. We thank the WMH Coordinating Center staff at Harvard and Michigan Universities, and especially Professor Ron Kessler, for assistance with instrumentation, fieldwork, and data management. A complete list of WMH publications can be found at https://www.hcp.med.harvard.edu/wmh.

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Authors and Affiliations

  1. Department of Social Medicine, Federal University of Espirito Santo, Vitória, Brazil

    Débora Costa Sena Pereira, Rafael Bello Corassa & Maria Carmen Viana

  2. National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

    Evandro Silva Freire Coutinho

  3. Section of Psychiatric Epidemiology, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil

    Laura Helena Andrade

  4. Centro de Ciências da Saúde, Av. Mal. Campos, 1468, Vitória, CEP 29047-105, Brazil

    Débora Costa Sena Pereira

Authors
  1. Débora Costa Sena Pereira
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  2. Evandro Silva Freire Coutinho
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  3. Rafael Bello Corassa
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  4. Laura Helena Andrade
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  5. Maria Carmen Viana
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Correspondence to Débora Costa Sena Pereira.

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Pereira, D.C.S., Coutinho, E.S.F., Corassa, R.B. et al. Prevalence and psychiatric comorbidities of intermittent explosive disorders in Metropolitan São Paulo, Brazil. Soc Psychiatry Psychiatr Epidemiol 56, 687–694 (2021). https://doi.org/10.1007/s00127-020-01869-x

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  • DOI: https://doi.org/10.1007/s00127-020-01869-x

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