The prevalence of impulse control disorders among patients with major depression

Aim: The aim of this study was to determine the prevalence rates of impulse control disorders among major depressive patients and evaluate the effect of comorbidity on the onset and the clinical course of depression.Material and Methods: The study included 150 consecutive depressive psychiatric patients who have been referred to our outpatient clinics in one year period. A demographic data form has been completed along with a structural clinical interview (SCID-I) to evaluate axis I psychiatric disorders according to Diagnostic and statistical Manual of Mental Disorders-IV To determine the impulse control disorders and depression Minnesota Impulse Control Disorders Interview and Hamilton Depression Scale Interview has been conducted with all patients. Besides all patients completed Symptom Check List-90, Beck Depression Inventory, Zuckerman Sensation Seeking Scale Form-V, Barratt Impulsiveness Scale-11, Mood Disorders Questionnaire to help us to find out several psychopathology levels.Results: In one year period, 34,7 % of depressive outpatients in our clinics had at least one impulse control disorder comorbidity. The inclusion of patients with a daignosis of impulse control disorders not otherwise specified increases the number of patients with any impulse control disorders co morbidity to 56,7 %. The most common impulse control disorder in our sample was intermittent explosive disorder (31,3 %) followed by skin picking (28 %) and compulsive buying (14 %). Depressive patients with a comorbid impulse control disorder had an earlier age of onset of the disorder than patients without any impulse control disorder. There were no differences between groups in terms of gender, marital status, education level and number of hospitalization. Pathological gambling was more common in male patients whereas compulsive buying was more common in female patients. Lifetime suicide attempt rates were two times more common in depressive patients with comorbid impulse control disorder than patients without any impulse control disorder comorbidity but this difference did not reach statistical significance. Though there was not any statistically significant difference between these two groups, general psychopathology levels, impulsivity scores and mood disorders questionnaire scores were significantly higher in patients with comorbid impulse control disorder.Discussion: The results of this study have shown that one third of depressive patients had lifetime impulse control disorder comorbidity. Common occurrence of impulse control disorder comorbidity and ensuing complications in the course and treatment of depressive disorder necessitates close evaluation and recognition of impulse control disorder comorbidity.