Screening for Impulse Control Disorders Among Patients Admitted to a French Psychiatric Emergency Service

Objective: The authors want to examine the prevalence of all impulse control disorders (ICD) among patients examined in a French psychiatric emergency ward and to compare patients with and without ICD. Method: 210 consecutive patients examined in a psychiatric emergency ward were included. We used the Minnesota Impulsive Disorders Interview, a semi-structured clinical interview assessing impulse control disorders (ICD): compulsive buying, trichotillomania, compulsive sexual behavior, kleptomania, pyromania and intermittent explosive disorder. We assessed the DSM-IV-TR criteria for personality disorders and we used the Zuckerman scale to study the level of sensation-seeking. All patients answered in addition the South Oaks Gambling Screen (SOGS) for pathological gambling, the Lejoyeux scale of compulsive buying, the DETA questionnaire for alcohol use disorders and the Fagerström questionnaire for nicotine consumption. Results: Fifty-four patients (25%) showed signs of at least one ICD. Fifteen patients (7%) reported current symptoms of two impulse control disorders. The most common impulse control disorders were compulsive buying (N=41, 19.5%), pathological gambling (N=13, 6.2%) and intermittent explosive disorder (N=11, 5.2%). Psychiatric comorbidity was not different between patients from the ICD+ and the ICD– groups. Alcohol, nicotine and cannabis consumption were equivalent in the ICD+ and ICDgroups. Patients with co-occurring impulse control disorders were younger. They had a higher score of pathological gambling assessed with the SOGS and a higher level of sensation seeking. Sub-scores of disinhibition, experience seeking and boredom susceptibility were also significantly higher. Conclusion: An important proportion of patients (25%) examined in a French psychiatric emergency service shows at least one diagnosis of impulse control disorder. Emergency ward may give them an opportunity for identifying ICD and offering information and treatment. Additional research could try to validate effective treatment for psychiatric patients with impulse control disorder.