Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Germany.
Psychiatry Res. 2011 Aug 15;188(3):434-8. doi: 10.1016/j.psychres.2011.04.006. Epub 2011 May 5.
The aim of this study was to examine the prevalence of impulse control disorders (ICDs) in a European psychiatric inpatient sample. Two hundred thirty four consecutive psychiatric inpatients (62% female) were examined using a module of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) that has been developed for ICDs (SCID-ICD). In addition to intermittent explosive disorder, pyromania, kleptomania, pathological gambling, and trichotillomania, the proposed ICDs not otherwise specified were assessed, including compulsive buying, nonparaphilic compulsive sexual behavior, pathological internet use, and pathological skin picking. Based on the SCID-ICD, a lifetime ICD rate of 23.5% and a current ICD rate of 18.8% were found. The most frequent ICDs were pathological skin picking (lifetime 7.3%, current 6.8%), compulsive buying (lifetime 6.8%, current 6.0%), and intermittent explosive disorder (lifetime 5.6%, current 3.4%). In contrast, referring to admission diagnoses taken from patients' charts only 3.8% of the inpatients were diagnosed with any current ICD. Individuals with comorbid ICD were significantly younger and had more admission diagnoses other than ICD. The results suggest high rates of ICDs among psychiatric inpatients that remain to be under-diagnosed in clinical routine.
本研究旨在调查欧洲精神病住院患者中冲动控制障碍（ICD）的患病率。采用专门针对 ICD 开发的诊断和统计手册第四版（DSM-IV）结构化临床访谈模块（SCID-ICD），对 234 名连续精神病住院患者（62%为女性）进行了检查。除间歇性爆发障碍、纵火狂、盗窃癖、病理性赌博和拔毛癖外，还评估了拟议的 ICD 未特定情况，包括强迫性购物、非性癖好强迫性行为、病理性网络使用和病理性皮肤搔抓。根据 SCID-ICD，发现终生 ICD 患病率为 23.5%，当前 ICD 患病率为 18.8%。最常见的 ICD 是病理性皮肤搔抓（终生 7.3%，当前 6.8%）、强迫性购物（终生 6.8%，当前 6.0%）和间歇性爆发障碍（终生 5.6%，当前 3.4%）。相比之下，仅根据患者病历中的入院诊断，只有 3.8%的住院患者被诊断为当前存在任何 ICD。患有合并 ICD 的个体明显更年轻，且入院诊断除 ICD 外还有更多其他诊断。研究结果表明，精神病住院患者中 ICD 的发病率较高，但在临床常规中仍未得到充分诊断。
