Recent studies suggest that intermittent explosive disorder (IED) may be more prevalent than previously recognized, but its comorbidities and functional impacts, particularly in non-Western populations, are not well understood. This study estimates the prevalence of psychiatric comorbidities in IED and explores its relationships with other mental disorders, suicidality, and functional impairment in a nationally representative sample from mainland China. Data from the China Mental Health Survey (2013–2015) were analyzed, including 28,140 adults. IED was assessed using the Composite International Diagnostic Interview, and five behavioral subtypes were identified. Logistic regression explored the associations between these subtypes and lifetime comorbidity, suicidality, and 12-month functional impairment. The weighted 12-month and lifetime prevalence of IED were 1.23% and 1.54%, respectively. Comorbidity was common, with 61.87% of individuals with IED having at least one comorbid disorder, most notably mood disorders (55.1%). The highest likelihood of comorbidity was observed in the “destroy property and hurt people” subtype (OR: 17.2; 95% CI: 7.4–41.8). Of the 391 individuals, 4.77% had ever consulted a medical doctor or other professional about their anger attacks, and 7.27% accessed mental health services. Approximately 4.45% (SE: 1.49) reported suicidal ideation, 1.79% (SE: 0.91) had a suicidal plan, and 0.88% (SE: 0.51) reported suicide attempts or gestures. Among those with 12-month IED, 10.57% reported severe functional impairment. IED is common in China but has low service utilization and high comorbidity, potentially leading to underreported impairment. These findings highlight the need for increased awareness, research, and culturally sensitive management. • This first national survey in China reveals a lifetime IED prevalence of 1.54%, indicating it is a common but overlooked mental health issue. • IED shows high psychiatric comorbidity, with over 60% of cases having another disorder, and strong links to mood disorders and suicidality. • The “destroy property and hurt people” subtype carries the highest risk for comorbid disorders (OR: 17.2). • Critical service gap: fewer than 8% of individuals with IED accessed mental health services, despite significant functional impairment. • Findings underscore an urgent need for public health awareness and culturally adapted interventions for IED in China.
Ding et al. (Sun,) studied this question.