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

To examine in a sex-sensitive manner the frequencies, clinical correlates, and patterns of co-occurrence of impulse-control disorders in adolescent psychiatric inpatients.

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.

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).

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.