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episodic dyscontrol syndrome; intermittent explosive disorder; impulse control disorder

Abnormal, episodic, & frequently violent & uncontrollable behavior in the absence of significant provocation. Classification: - axis 1 disorder Etiology: - limbic system pathology - temporal lobe pathology - substance abuse Clinical manifestations: - expressions of anger disproportionate to the situation - failure to control aggressive impulses [7] Differential diagnosis: - other disorders that may cause violent outbursts - antisocial personality disorder - borderline personality disorder - unstable interpersonal relationships (frantic efforts to avoid abandonment), emotional lability. impulsivity, low self esteem [7] - attention deficit hyperactivity disorder Management: - cognitive behavioral therapy [6] - pharmaceuticals - antidepressants of benefit - SSRI - tricyclic antidepressants - anticonvulsants of benefit - lithium carbonate of benefit

General

impulse control disorder syndrome chronic mental disorder

References

  1. McElroy SL Recognition and treatment of DSM-IV intermittent explosive disorder J Clin Psychiatry (1999) 60 Suppl 15:12-6 PMID: 10418808
  2. Kessler RC et al The prevalence and correlates of DSM-IV intermittent explosive disorder in the National Comorbidity Survey Replication Arch. Gen. Psychiatry 2006 63(6):669 PMID: 16754840
  3. Coccaro EF et al Prevalence and features of intermittent explosive disorder in a clinical setting J Clin Psychiatry 2005 66(10):1221 PMID: 16259534
  4. Wikipedia Intermittent Explosive Disorder http://en.wikipedia.org/wiki/Intermittent_explosive_disorder - Episodic dyscontrol syndrome http://en.wikipedia.org/wiki/Episodic_dyscontrol_syndrome
  5. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association. 2000. pg. 663
  6. Okai D et al. Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers. Neurology 2013 Jan 16 PMID: 23325911 http://www.neurology.org/content/80/9/792 - Macphee GJA and Carson A. Impulse control disorders in Parkinson disease: Is cognitive-behavior therapy worth a wager? Neurology 2013 Jan 16 PMID: 23325905 http://www.neurology.or g/content/80/9/782
  7. NEJM Knowledge+ Psychiatry