Angry Without Borders: Global prevalence and factors of intermittent explosive disorder: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to synthesie global data on the prevalence, determinants, and moderators of Intermittent Explosive Disorder (IED). Analyzing 29 studies (N = 182,112 participants across 17 countries), pooled lifetime and 12-month prevalence estimates were 5.1% (95% CI: 3.4–7.5%) and 4.4% (95% CI: 2.9–6.7%), respectively. Prevalence varied significantly across subgroups, with higher rates in clinical (10.5%), refugee (8.5%), and adolescent populations. Male gender (OR = 3.39), younger age, trauma exposure (dose-response relationship), and psychiatric comorbidities (mood, anxiety, and substance use disorders) emerged as robust risk factors. Studies using DSM-5 criteria reported lower prevalence than DSM-IV. Regional disparities were notable, with elevated rates in conflict-affected and Global South regions. Heterogeneity was partially explained by population type, diagnostic criteria, and sociocultural context. Findings underscore the multifactorial etiology of IED, shaped by biological vulnerabilities, trauma, and structural adversities. A tiered intervention framework integrating universal prevention, targeted therapies, and policy advocacy is therefore proposed to address its global burden.