Fincham Dylan, Grimsrud Anna, Corrigall Joanne, Williams David R, Seedat Soraya, Stein Dan J, Myer Landon
MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa.
Psychopathology. 2009;42(2):92-8. doi: 10.1159/000203341. Epub 2009 Feb 19.
The epidemiology of DSM-IV intermittent explosive disorder (IED) is not well characterized in developing country settings. In South Africa, given the high rates of violence and trauma, there is particular interest in traumatic exposures as potential risk factors for IED.
We examined the prevalence and predictors of IED in a nationally representative sample of 4,351 South African adults. IED and other diagnoses based on DSM-IV criteria were assessed using the World Health Organization Composite International Diagnostic Interview (CIDI). A 28-item scale was constructed to measure exposure to traumatic events.
Overall, 2.0% of participants (95% CI: 0-4.9%) fulfilled criteria for the narrow definition of IED, and 9.5% (95% CI: 6.6-12.3%) fulfilled criteria for the broad definition of IED. Individuals with IED experienced high rates of comorbid anxiety, mood and substance use disorders compared to non-IED participants. In multivariate analysis, a diagnosis of IED was associated with Caucasian and mixed-race ethnicity, psychiatric comorbidity and exposure to multiple traumatic events.
These data suggest a relatively high prevalence of IED in South Africa. By reducing violence and trauma, and by providing appropriate psychological support to trauma survivors, we may be able to reduce rates of IED.
在发展中国家，DSM-IV间歇性爆发障碍（IED）的流行病学特征尚不明确。在南非，鉴于暴力和创伤发生率较高，人们尤其关注创伤暴露作为IED潜在危险因素的情况。
我们在一个具有全国代表性的4351名南非成年人样本中研究了IED的患病率及预测因素。基于DSM-IV标准的IED及其他诊断使用世界卫生组织综合国际诊断访谈（CIDI）进行评估。构建了一个28项量表来测量创伤事件暴露情况。
总体而言，2.0%的参与者（95%置信区间：0 - 4.9%）符合IED狭义定义标准，9.5%（95%置信区间：6.6 - 12.3%）符合IED广义定义标准。与非IED参与者相比，IED患者共患焦虑、情绪和物质使用障碍的比例较高。在多变量分析中，IED诊断与白种人和混血种族、精神疾病共病以及暴露于多种创伤事件相关。
这些数据表明南非IED患病率相对较高。通过减少暴力和创伤，并为创伤幸存者提供适当的心理支持，我们或许能够降低IED的发生率。
