Impulse-control disorders in adolescent psychiatric inpatients: co-occurring disorders and sex differences

J Clin Psychiatry. 2007 Oct;68(10):1584-92. doi: 10.4088/jcp.v68n1018.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Comorbidity
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / rehabilitation*
  • Sex Distribution