Individuals with intermittent explosive disorder had increased risk for substance use disorders, which suggests aggressive behavior may be an indicator of substance use disorder risk.
“A relationship between aggression and [substance use disorders] has been discussed in the literature for many years,” Emil F. Coccaro, MD, of the University of Chicago, and colleagues wrote. “In general, substance use increases the risk of aggressive behavior. Notably, alcohol, cocaine, amphetamines, and cannabis have been found to increase the risk for aggressive behavior in human subjects.”
Emil F. Coccaro
To assess associations between intermittent explosive disorder and substance use disorders, researchers analyzed data from the community-based National Comorbidity Survey Replication (n = 9,282).
Participants with intermittent explosive disorder were more likely to have current substance use disorders, compared with those without intermittent explosive disorder.
Onset of intermittent explosive disorder preceded substance use disorders in 92.5% of participants with comorbid intermittent explosive and substance use disorder. Presence or absence of current depressive or anxiety disorders did not influence this relationship, according to researchers.
The presence of intermittent explosive disorder increased severity of substance use disorders, but substance use disorders did not increase severity of intermittent explosive disorder.
“The current presence of [intermittent explosive disorder] is associated with a statistically significant increase in the risk of current [substance use disorder]. At the same time, the onset of [intermittent explosive disorder] precedes that of [substance use disorder] in more than 90% of comorbid cases,” the researchers wrote. “Accordingly, individuals with [intermittent explosive disorder] are at increased risk of developing [substance use disorder] at some time after the onset of [intermittent explosive disorder]. This may be because [intermittent explosive disorder] is an early indicator of a more severe impulsive externalizing liability that expresses in later substance use. If so, effective treatment of impulsive aggression, before the onset of substance misuse, may prevent, or delay, the development of [substance use disorder] in young people.” – by Amanda Oldt
Disclosure: Coccaro reports serving on the scientific advisory board of Azevan Pharmaceuticals. Please see the study for a full list of relevant financial disclosures.