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Impulse-Control Disorders in Adolescent Psychiatric Inpatients: Co-Occurring Disorders and Sex Differences
Jon E. Grant, J.D., M.D.; Kyle A. Williams, B.A.; and Marc N. Potenza, M.D., Ph.D.
Objective: To examine in a sex-sensitive manner the frequencies, clinical correlates, and patterns of co-occurrence of impulse-control disorders in adolescent psychiatric inpatients.
Method: 102 consecutive adolescents (54.9% females; mean age = 15.8 ± 1.4 years) admitted to an inpatient psychiatric service for a variety of disorders were screened for impulse-control disorders from January through June 2006 using the Minnesota Impulsive Disorders Interview. Subjects screening positive were blindly evaluated with structured clinical interviews.
Results: Forty-one patients (40.2%) met criteria for a current impulse-control disorder. The most common impulse-control disorder was intermittent explosive disorder (12.7%). Compared to patients without impulse-control disorders, those with impulse-control disorders were more likely to report previous psychiatric hospitalization (75.6% vs. 41.0%; p = .001) and internalizing disorders (78.0% vs. 55.7%; p = .04). Although not statistically significantly different, a numerically larger proportion of girls as compared with boys had an impulse-control disorder (48.2% vs. 30.4%; p = .07). In particular, a statistically greater percentage of females had pyromania (12.5% vs. 0%; p = .02).
Conclusions: Impulse-control disorders are common among adolescent psychiatric inpatients, with a trend toward impulse-control disorders being more common in girls. Impulse-control disorders appear associated with more severe psychiatric illness. Sex-specific patterns of impulse-control disorder occurrence in adults do not appear uniformly applicable to adolescent psychiatric inpatients. Better identification of impulse-control disorders in adolescents is needed, as are empirically validated treatments for adolescents with co-occurring impulse-control disorders.
(J Clin Psychiatry 2007;68:1584-1592)
Received Nov. 12, 2006; accepted Feb. 9, 2007. From the University of Minnesota Medical School, Minneapolis (Dr. Grant and Mr. Williams); Yale University School of Medicine, New Haven (Dr. Potenza); and VA Connecticut Healthcare System, West Haven, Conn. (Dr. Potenza).
This research was supported in part by a Career Development Award (K23 MH069754-01A1) to Dr. Grant and by support from the National Institute on Drug Abuse (NIDA; grant R01 DA019039), Women's Health Research at Yale, and the United States Department of Veterans Affairs Research Enhancement Award Program and Mental Illness Research Education and Clinical Center to Dr. Potenza. Dr. Grant had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr. Grant has received grant/research support from GlaxoSmithKline, Somaxon, and Forest. Dr. Potenza has served as a consultant to Boehringer-Ingelheim and Somaxon and has received grant/research support from the National Institutes of Health, the U.S. Department of Veterans Affairs, NIDA, and Women's Health Research at Yale. Mr. Williams reports no financial or other relationship relative to the subject of this article.
Corresponding author and reprints: Jon E. Grant, J.D., M.D., Department of Psychiatry, University of Minnesota Medical School, 2450 Riverside Ave., Minneapolis, MN 55454 (e-mail: firstname.lastname@example.org).