Epidemiology of impulse control disorders and association with dopamine agonist exposure, active component, u.S. armed forces, 2014–2018

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-trau-matic 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=12.00; 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.