Epidemiology of impulse control disorders and association with dopamine agonist exposure, active component, U.S. Armed Forces, 2014-2018

• Published in: MSMR (U.S. Army Center for Health Promotion and Preventive Medicine, Executive Communications Division) Vol. 26; no. 8; p. 10
• Main Authors: Garrett, Andrew R, Bazaco, Sara L, Clausen, Shawn S, Oetting, Alexis A, Stahlman, Shauna
• Format: Journal Article
• Language: English
• Published: United States 01.08.2019
• Subjects: Adult; Age Distribution; Case-Control Studies; Disruptive, Impulse Control, and Conduct Disorders - chemically induced; Disruptive, Impulse Control, and Conduct Disorders - epidemiology; Dopamine Agonists - administration & dosage; Dopamine Agonists - adverse effects; Female; Fibromyalgia - drug therapy; Humans; Incidence; Male; Mental Disorders - drug therapy; Mental Disorders - epidemiology; Middle Aged; Military Personnel - statistics & numerical data; Population Surveillance; Sex Distribution; United States - epidemiology; Young Adult; United States
• ISSN: 2152-8217

Impulse control disorders (ICDs) are a group of behavioral disorders characterized by failure to resist impulsive thoughts and behaviors that can lead to significant adverse social, legal, and financial consequences. ICDs have been associated with previous diagnoses of depression, anxiety, and post-traumatic stress disorder and have been widely recognized as an adverse effect of dopamine agonist (DA) therapy. The epidemiology of these disorders in the U.S. Armed Forces is unknown. The current study evaluated the incidence of ICD diagnoses in the U.S. Armed Forces during 2014-2018. The overall incidence was 13.7 per 10,000 person-years (p-yrs), with the highest rates among females and younger personnel. The current case-control study evaluated the association between DA exposure in the year preceding an incident ICD diagnosis. Although few individuals had received DA therapy in the past year, DA therapy was independently associated with incident ICD diagnosis (adjusted odds ratio [AOR]=2.34; 95% confidence interval [CI]: 1.29-4.24, p<.0001). Previous mental health disorder diagnosis (AOR=12.0; 95% CI: 11.09-12.98, p<.0001) and fibromyalgia (AOR=1.30; 95% CI: 1.14-1.48, p<.0001) were also associated with incident ICD diagnosis. The impact of ICDs on mission readiness, medical evacuation, and deployability should be further evaluated.