episodic dyscontrol syndrome; intermittent explosive disorder; impulse control disorder

Introduction

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

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
  • attention deficit hyperactivity disorder

Management

• cognitive behavioral therapy
• pharmaceuticals
  • antidepressants of benefit
    • SSRI
    • tricyclic antidepressants
• anticonvulsants of benefit
• lithium carbonate of benefit

More general terms

• impulse control disorder
• syndrome
• chronic mental disorder