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id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Intermittent explosive disorder</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 20 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-20" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">20 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%84%D8%A7%D8%B6%D8%B7%D8%B1%D8%A7%D8%A8_%D8%A7%D9%84%D8%A7%D9%86%D9%81%D8%AC%D8%A7%D8%B1%D9%8A_%D8%A7%D9%84%D9%85%D8%AA%D9%82%D8%B7%D8%B9" title="الاضطراب الانفجاري المتقطع – Arabic" lang="ar" hreflang="ar" data-title="الاضطراب الانفجاري المتقطع" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Trastorn_explosiu_intermitent" title="Trastorn explosiu intermitent – Catalan" lang="ca" hreflang="ca" data-title="Trastorn explosiu intermitent" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Lejlighedsvis_eksplosiv_forstyrrelse" title="Lejlighedsvis eksplosiv forstyrrelse – Danish" lang="da" hreflang="da" data-title="Lejlighedsvis eksplosiv forstyrrelse" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Trastorno_explosivo_intermitente" title="Trastorno explosivo intermitente – Spanish" lang="es" hreflang="es" data-title="Trastorno explosivo intermitente" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Aldizkako_nahasmendu_leherkor" title="Aldizkako nahasmendu leherkor – Basque" lang="eu" hreflang="eu" data-title="Aldizkako nahasmendu leherkor" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A7%D8%AE%D8%AA%D9%84%D8%A7%D9%84_%D8%A7%D9%86%D9%81%D8%AC%D8%A7%D8%B1%DB%8C_%D9%85%D8%AA%D9%86%D8%A7%D9%88%D8%A8" title="اختلال انفجاری متناوب – Persian" lang="fa" hreflang="fa" data-title="اختلال انفجاری متناوب" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Trouble_explosif_intermittent" title="Trouble explosif intermittent – French" lang="fr" hreflang="fr" data-title="Trouble explosif intermittent" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B0%84%ED%97%90%EC%A0%81_%ED%8F%AD%EB%B0%9C%EC%84%B1_%EC%9E%A5%EC%95%A0" title="간헐적 폭발성 장애 – Korean" lang="ko" hreflang="ko" data-title="간헐적 폭발성 장애" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B8%E0%A4%B5%E0%A4%BF%E0%A4%B0%E0%A4%BE%E0%A4%AE_%E0%A4%B5%E0%A4%BF%E0%A4%B8%E0%A5%8D%E0%A4%AB%E0%A5%8B%E0%A4%9F%E0%A5%80_%E0%A4%B5%E0%A4%BF%E0%A4%95%E0%A4%BE%E0%A4%B0" title="सविराम विस्फोटी विकार – Hindi" lang="hi" hreflang="hi" data-title="सविराम विस्फोटी विकार" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Disturbo_esplosivo_intermittente" title="Disturbo esplosivo intermittente – Italian" lang="it" hreflang="it" data-title="Disturbo esplosivo intermittente" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%A4%D7%A8%D7%A2%D7%AA_%D7%94%D7%AA%D7%A4%D7%A8%D7%A6%D7%95%D7%AA_%D7%9C%D7%A1%D7%99%D7%A8%D7%95%D7%92%D7%99%D7%9F" title="הפרעת התפרצות לסירוגין – Hebrew" lang="he" hreflang="he" data-title="הפרעת התפרצות לסירוגין" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Periodieke_explosieve_stoornis" title="Periodieke explosieve stoornis – Dutch" lang="nl" hreflang="nl" data-title="Periodieke explosieve stoornis" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E9%96%93%E6%AC%A0%E6%80%A7%E7%88%86%E7%99%BA%E6%80%A7%E9%9A%9C%E5%AE%B3" title="間欠性爆発性障害 – Japanese" lang="ja" hreflang="ja" data-title="間欠性爆発性障害" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Eksplosiv_personlighetsforstyrrelse" title="Eksplosiv personlighetsforstyrrelse – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Eksplosiv personlighetsforstyrrelse" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Zaburzenie_eksplozywne_przerywane" title="Zaburzenie eksplozywne przerywane – Polish" lang="pl" hreflang="pl" data-title="Zaburzenie eksplozywne przerywane" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Transtorno_explosivo_intermitente" title="Transtorno explosivo intermitente – Portuguese" lang="pt" hreflang="pt" data-title="Transtorno explosivo intermitente" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Raivopuuskasyndrooma" title="Raivopuuskasyndrooma – Finnish" lang="fi" hreflang="fi" data-title="Raivopuuskasyndrooma" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Intermittent_explosivitet" title="Intermittent explosivitet – Swedish" lang="sv" hreflang="sv" data-title="Intermittent explosivitet" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9F%D0%B5%D1%80%D1%96%D0%BE%D0%B4%D0%B8%D1%87%D0%BD%D0%B8%D0%B9_%D0%B2%D0%B8%D0%B1%D1%83%D1%85%D0%BE%D0%B2%D0%B8%D0%B9_%D1%80%D0%BE%D0%B7%D0%BB%D0%B0%D0%B4" title="Періодичний вибуховий розлад – Ukrainian" lang="uk" hreflang="uk" data-title="Періодичний вибуховий розлад" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E9%96%93%E6%AD%87%E6%80%A7%E6%9A%B4%E6%80%92%E7%97%87" title="間歇性暴怒症 – Chinese" lang="zh" hreflang="zh" data-title="間歇性暴怒症" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit 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<div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Behavioral disorder</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Intermittent explosive disorder</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Episodic dyscontrol syndrome (EDS), dyscontrol <sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Dante_Gabriel_Rossetti_-_Christina_Rossetti_in_a_Tantrum.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/35/Dante_Gabriel_Rossetti_-_Christina_Rossetti_in_a_Tantrum.jpg/220px-Dante_Gabriel_Rossetti_-_Christina_Rossetti_in_a_Tantrum.jpg" decoding="async" width="220" height="273" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/35/Dante_Gabriel_Rossetti_-_Christina_Rossetti_in_a_Tantrum.jpg/330px-Dante_Gabriel_Rossetti_-_Christina_Rossetti_in_a_Tantrum.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/35/Dante_Gabriel_Rossetti_-_Christina_Rossetti_in_a_Tantrum.jpg/440px-Dante_Gabriel_Rossetti_-_Christina_Rossetti_in_a_Tantrum.jpg 2x" data-file-width="484" data-file-height="600" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Cartoon of <a href="/wiki/Christina_Rossetti" title="Christina Rossetti">Christina Rossetti</a> in a fit of anger, drawn by her brother <a href="/wiki/Dante_Gabriel_Rossetti" title="Dante Gabriel Rossetti">Dante</a> (1862).</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Explosive outbursts of <a href="/wiki/Anger" title="Anger">anger</a> and/or violence, often to the point of rage, that are disproportionate to the situation at hand</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Alcoholism" title="Alcoholism">Alcoholism</a>, <a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">post-traumatic stress disorder</a>, <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>, <a href="/wiki/Antisocial_personality_disorder" title="Antisocial personality disorder">antisocial personality disorder</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">Cognitive behavioral therapy</a>, <a href="/wiki/Medication" title="Medication">medication</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">3%</td></tr></tbody></table> <p><b>Intermittent explosive disorder</b> (<b>IED</b>) is a <a href="/wiki/Mental_disorder" title="Mental disorder">mental</a> and <a href="/wiki/Abnormality_(behavior)" title="Abnormality (behavior)">behavioral disorder</a> characterized by explosive outbursts of <a href="/wiki/Anger" title="Anger">anger</a> and/or violence, often to the point of <a href="/wiki/Rage_(emotion)" title="Rage (emotion)">rage</a>, that are disproportionate to the situation at hand (e.g., impulsive shouting, screaming or excessive reprimanding triggered by relatively inconsequential events). Impulsive aggression is not premeditated, and is defined by a disproportionate reaction to any provocation, real or perceived. Some individuals have reported <a href="/wiki/Affective" class="mw-redirect" title="Affective">affective</a> changes prior to an outburst, such as <a href="/wiki/Stress_(biology)" title="Stress (biology)">tension</a>, <a href="/wiki/Mood_(psychology)" title="Mood (psychology)">mood</a> changes, and <a href="/wiki/Energy" title="Energy">energy</a> changes.<sup id="cite_ref-McElroy_3-0" class="reference"><a href="#cite_note-McElroy-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>The disorder is currently categorized in the <i><a href="/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders" title="Diagnostic and Statistical Manual of Mental Disorders">Diagnostic and Statistical Manual of Mental Disorders</a></i> (DSM-5) under the "Disruptive, Impulse-Control, and Conduct Disorders" category. The disorder itself is not easily characterized and often exhibits <a href="/wiki/Comorbidity" title="Comorbidity">comorbidity</a> with other mood disorders, particularly <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>.<sup id="cite_ref-27cases_4-0" class="reference"><a href="#cite_note-27cases-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Individuals diagnosed with IED report their outbursts as being brief (lasting less than an hour), with a variety of bodily symptoms (sweating, stuttering, chest tightness, twitching, <a href="/wiki/Palpitation" class="mw-redirect" title="Palpitation">palpitations</a>) reported by a third of one sample.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Aggressive acts are frequently reported to be accompanied by a sensation of relief and in some cases pleasure, but often followed by later <a href="/wiki/Remorse" title="Remorse">remorse</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=1" title="Edit section: Pathophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Impulsive behavior, and especially impulsive violence predisposition, have been correlated to a low brain <a href="/wiki/Serotonin" title="Serotonin">serotonin</a> turnover rate, indicated by a low concentration of <a href="/wiki/5-Hydroxyindoleacetic_acid" title="5-Hydroxyindoleacetic acid">5-hydroxyindoleacetic acid</a> (5-HIAA) in the <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">cerebrospinal fluid</a> (CSF). This <a href="/wiki/Substrate_(biochemistry)" class="mw-redirect" title="Substrate (biochemistry)">substrate</a> appears to act on the <a href="/wiki/Suprachiasmatic_nucleus" title="Suprachiasmatic nucleus">suprachiasmatic nucleus</a> in the <a href="/wiki/Hypothalamus" title="Hypothalamus">hypothalamus</a>, which is the target for serotonergic output from the dorsal and median <a href="/wiki/Raphe_nuclei" title="Raphe nuclei">raphe nuclei</a> playing a role in maintaining the <a href="/wiki/Circadian_rhythm" title="Circadian rhythm">circadian rhythm</a> and regulation of <a href="/wiki/Blood_sugar" class="mw-redirect" title="Blood sugar">blood sugar</a>. A tendency towards low 5-HIAA may be <a href="/wiki/Heredity" title="Heredity">hereditary</a>. A putative hereditary component to low CSF 5-HIAA and concordantly possibly to impulsive violence has been proposed. Other traits that <a href="/wiki/Correlation" title="Correlation">correlate</a> with IED are low <a href="/wiki/Vagal_tone" title="Vagal tone">vagal tone</a> and increased <a href="/wiki/Insulin" title="Insulin">insulin</a> secretion. A suggested explanation for IED is a <a href="/wiki/Polymorphism_(biology)" title="Polymorphism (biology)">polymorphism</a> of the <a href="/wiki/Gene" title="Gene">gene</a> for <a href="/wiki/Tryptophan_hydroxylase" title="Tryptophan hydroxylase">tryptophan hydroxylase</a>, which produces a serotonin <a href="/wiki/Precursor_(chemistry)" title="Precursor (chemistry)">precursor</a>; this <a href="/wiki/Genotype" title="Genotype">genotype</a> is found more commonly in individuals with impulsive behavior.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>IED may also be associated with damage or <a href="/wiki/Lesions" class="mw-redirect" title="Lesions">lesions</a> in the <a href="/wiki/Prefrontal_cortex" title="Prefrontal cortex">prefrontal cortex</a>, with damage to these areas, including the <a href="/wiki/Amygdala" title="Amygdala">amygdala</a> and <a href="/wiki/Hippocampus" title="Hippocampus">hippocampus</a>, increasing the incidences of impulsive and aggressive behavior and the inability to predict the outcomes of an individual's own actions. Lesions in these areas are also associated with improper blood sugar control, leading to decreased brain function in these areas, which are associated with planning and decision making.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> A national sample in the <a href="/wiki/United_States" title="United States">United States</a> estimated that 16 million Americans may fit the criteria for IED.<sup id="cite_ref-Kessler2006_8-0" class="reference"><a href="#cite_note-Kessler2006-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>EDS was associated with <a href="/wiki/Limbic_system" title="Limbic system">limbic system</a> diseases, disorders of the <a href="/wiki/Temporal_lobe" title="Temporal lobe">temporal lobe</a>,<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> or <a href="/wiki/Substance_abuse" title="Substance abuse">abuse</a> of <a href="/wiki/Ethanol" title="Ethanol">alcohol</a> or other <a href="/wiki/Psychoactive_drug" title="Psychoactive drug">psychoactive</a> substances.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=2" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="DSM-5_diagnosis">DSM-5 diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=3" title="Edit section: DSM-5 diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The current <a href="/wiki/DSM-5" title="DSM-5">DSM-5</a> criteria for Intermittent Explosive Disorder include:<sup id="cite_ref-American_Psychiatric_Association_12-0" class="reference"><a href="#cite_note-American_Psychiatric_Association-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Recurrent outbursts that demonstrate an inability to control impulses, including either of the following: <ul><li>Verbal aggression (tantrums, verbal arguments, or fights) or physical aggression that occurs twice in a week-long period for at least three months and does not lead to the destruction of property or physical injury (Criterion A1)</li> <li>Three outbursts that involve injury or destruction within a year-long period (Criterion A2)</li></ul></li> <li>Aggressive behavior is grossly disproportionate to the magnitude of the <a href="/wiki/Social_stress" title="Social stress">psychosocial stressors</a> (Criterion B)</li> <li>The outbursts are not premeditated and serve no premeditated purpose (Criterion C)</li> <li>The outbursts cause distress or impairment of functioning or lead to financial or legal consequences (Criterion D)</li> <li>The individual must be at least six years old (Criterion E)</li> <li>The recurrent outbursts cannot be explained by another mental disorder and are not the result of another medical disorder or substance use (Criterion F)</li></ul> <p>It is important to note that DSM-5 now includes two separate criteria for types of aggressive outbursts (A1 and A2) which have empirical support:<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Criterion A1: Episodes of verbal and/or non-damaging, nondestructive, or non-injurious physical assault that occur, on average, twice weekly for three months. These could include temper tantrums, tirades, verbal arguments/fights, or assault without damage. This criterion includes high frequency/low-intensity outbursts.</li> <li>Criterion A2: More severe destructive/assaultive episodes which are more infrequent and occur, on average, three times within a twelve-month period. These could be destroying an object without regard to value or assaulting an animal or individual. This criterion includes high-intensity/low-frequency outbursts.</li></ul> <div class="mw-heading mw-heading3"><h3 id="DSM-IV_diagnosis">DSM-IV diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=4" title="Edit section: DSM-IV diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The past <a href="/wiki/DSM-IV" class="mw-redirect" title="DSM-IV">DSM-IV</a> criteria for IED were similar to the current criteria, however, verbal aggression was not considered as part of the diagnostic criteria. The DSM-IV diagnosis was characterized by the occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property. Additionally, the degree of aggressiveness expressed during an episode should be grossly disproportionate to provocation or precipitating psychosocial stressor, and, as previously stated, diagnosis is made when certain other mental disorders have been ruled out, e.g., a head injury, <a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a>, etc., or due to <a href="/wiki/Substance_use_disorder" title="Substance use disorder">substance use</a> or medication.<sup id="cite_ref-27cases_4-1" class="reference"><a href="#cite_note-27cases-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Diagnosis is made using a psychiatric interview to affective and behavioral symptoms to the criteria listed in the DSM-IV.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/DSM-IV-TR" class="mw-redirect" title="DSM-IV-TR">DSM-IV-TR</a> was very specific in its definition of Intermittent Explosive Disorder which was defined, essentially, by the exclusion of other conditions. The diagnosis required: </p> <ol><li>several episodes of impulsive behavior that result in serious damage to either persons or property, wherein</li> <li>the degree of the aggressiveness is grossly disproportionate to the circumstances or provocation, and</li> <li>the episodic violence cannot be better accounted for by another mental or physical medical condition.</li></ol> <p>EDS was a category in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> EDS may affect children or adults.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Children are often considered to have epilepsy or a mental health problem. The episodes consist of recurrent attacks of uncontrollable rage, usually after minimal provocation, and may last up to an hour. Following an episode, children are frequently exhausted, may sleep and will usually have no recall.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Differential_diagnosis">Differential diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=5" title="Edit section: Differential diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Many psychiatric disorders and some substance use disorders are associated with increased aggression and are frequently comorbid with IED, often making differential diagnosis difficult. Individuals with IED are, on average, four times more likely to develop <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">depression</a> or <a href="/wiki/Anxiety_disorder" title="Anxiety disorder">anxiety disorders</a>, and three times more likely to develop <a href="/wiki/Substance_use_disorder" title="Substance use disorder">substance use disorders</a>.<sup id="cite_ref-Coccaro2012_20-0" class="reference"><a href="#cite_note-Coccaro2012-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">Bipolar disorder</a> has been linked to increased agitation and aggressive behavior in some individuals, but for these individuals, aggressiveness is limited to manic and/or depressive episodes, whereas individuals with IED experience aggressive behavior even during <a href="/wiki/Euthymia_(medicine)" title="Euthymia (medicine)">periods with a neutral or positive mood</a>.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p><p>In one clinical study, bipolar and IED disorders co-occurred 60% of the time. Patients report <a href="/wiki/Mania" title="Mania">manic</a>-like symptoms occurring just before outbursts and continuing throughout. According to a study, the average onset age of IED was around five years earlier than the onset age of bipolar disorder, indicating a possible correlation between the two.<sup id="cite_ref-Coccaro2012_20-1" class="reference"><a href="#cite_note-Coccaro2012-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p>Similarly, <a href="/wiki/Alcoholism" title="Alcoholism">alcoholism</a> and other substance use disorders may exhibit increased aggressiveness, but unless this aggression is experienced outside of periods of acute intoxication and withdrawal, no diagnosis of IED is given. Studies suggest that childhood abuse and <a href="/wiki/Alcohol_Use_Disorder" class="mw-redirect" title="Alcohol Use Disorder">alcohol use disorder</a> are linked to increased aggression and IED.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> For chronic disorders, such as <a href="/wiki/PTSD" class="mw-redirect" title="PTSD">post-traumatic stress disorder</a> (PTSD), it is important to assess whether the level of aggression met IED criteria before the development of another disorder. In <a href="/wiki/Antisocial_personality_disorder" title="Antisocial personality disorder">antisocial personality disorder</a> (ASPD), interpersonal aggression is usually instrumental in nature (i.e., motivated by tangible rewards), whereas IED is more of an impulsive, unpremeditated reaction to situational stress.<sup id="cite_ref-Aboujaoude_23-0" class="reference"><a href="#cite_note-Aboujaoude-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=6" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Although there is no cure, treatment is attempted through <a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">cognitive behavioral therapy</a> and psychotropic medication regimens, though the pharmaceutical options have shown limited success.<sup id="cite_ref-McCloskey_24-0" class="reference"><a href="#cite_note-McCloskey-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> Therapy aids in helping the patient recognize the impulses in hopes of achieving a level of awareness and control of the outbursts, along with treating the emotional stress that accompanies these episodes. Multiple drug regimens are frequently indicated for IED patients. Cognitive Relaxation and Coping Skills Therapy (CRCST) has shown preliminary success in both group and individual settings compared to waitlist control groups.<sup id="cite_ref-McCloskey_24-1" class="reference"><a href="#cite_note-McCloskey-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> This therapy consists of 12 sessions, the first three focusing on relaxation training, then <a href="/wiki/Cognitive_restructuring" title="Cognitive restructuring">cognitive restructuring</a>, then <a href="/wiki/Exposure_therapy" title="Exposure therapy">exposure therapy</a>. The final sessions focus on resisting aggressive impulses and other preventative measures.<sup id="cite_ref-McCloskey_24-2" class="reference"><a href="#cite_note-McCloskey-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p><p>In France, antipsychotics such as <a href="/wiki/Cyamemazine" title="Cyamemazine">cyamemazine</a>, <a href="/wiki/Levomepromazine" title="Levomepromazine">levomepromazine</a> and <a href="/wiki/Loxapine" title="Loxapine">loxapine</a> are sometimes used.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2020)">citation needed</span></a></i>]</sup> </p><p><a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">Tricyclic antidepressants</a> and <a href="/wiki/Selective_serotonin_reuptake_inhibitors" class="mw-redirect" title="Selective serotonin reuptake inhibitors">selective serotonin reuptake inhibitors</a> (SSRIs, including <a href="/wiki/Fluoxetine" title="Fluoxetine">fluoxetine</a>, <a href="/wiki/Fluvoxamine" title="Fluvoxamine">fluvoxamine</a>, and <a href="/wiki/Sertraline" title="Sertraline">sertraline</a>) appear to alleviate some pathopsychological symptoms.<sup id="cite_ref-McElroy_3-1" class="reference"><a href="#cite_note-McElroy-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> GABAergic <a href="/wiki/Mood_stabilizer" title="Mood stabilizer">mood stabilizers</a> and anticonvulsive drugs such as <a href="/wiki/Gabapentin" title="Gabapentin">gabapentin</a>, <a href="/wiki/Lithium_(medication)" title="Lithium (medication)">lithium</a>, <a href="/wiki/Carbamazepine" title="Carbamazepine">carbamazepine</a>, and <a href="/wiki/Divalproex" class="mw-redirect" title="Divalproex">divalproex</a> seem to aid in controlling the incidence of outbursts.<sup id="cite_ref-McElroy_3-2" class="reference"><a href="#cite_note-McElroy-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Boyd_26-0" class="reference"><a href="#cite_note-Boyd-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Anxiolytics help alleviate tension and may help reduce explosive outbursts by increasing the provocative stimulus tolerance threshold, and are especially indicated in patients with comorbid obsessive-compulsive or other anxiety disorders.<sup id="cite_ref-Boyd_26-1" class="reference"><a href="#cite_note-Boyd-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Former_treatments_for_EDS">Former treatments for EDS</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=7" title="Edit section: Former treatments for EDS"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Treatment for EDS usually involved treating the underlying causative factor(s). This may involve <a href="/wiki/Psychotherapy" title="Psychotherapy">psychotherapy</a>, or medical treatment for diseases.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p><p>EDS has been successfully controlled in <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trials</a> using prescribed medications, including <a href="/wiki/Carbamazepine" title="Carbamazepine">carbamazepine</a>,<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Ethosuximide" title="Ethosuximide">ethosuximide</a>,<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Propranolol" title="Propranolol">propranolol</a>.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p><p>There have been few randomised controlled trials of treatment of EDS/IED. Antidepressants and mood-stabilisers including lithium, sodium valproate and carbamazepine have been used in adults, and occasionally in children with oppositional defiant disorder or conduct disorder to reduce aggression. Cognitive behavioural therapy (CBT) is effective in the treatment of anger. A recent trial randomised adults with IED to 12 weeks of individual therapy, group therapy or waiting list (no therapy). Intervention resulted in an improvement in anger and aggression levels, with no difference between group and individual CBT (Cognitive behavioural therapy). Adolescents and young adults may experience educational and social consequences but also mental health problems, including parasuicide, if IED/EDS is undiagnosed in early childhood.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=8" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Two epidemiological studies of community samples approximated the lifetime prevalence of IED to be 4–6%, depending on the criteria set used.<sup id="cite_ref-Kessler2006_8-1" class="reference"><a href="#cite_note-Kessler2006-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Coccaro2004_35-0" class="reference"><a href="#cite_note-Coccaro2004-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> A Ukrainian study found comparable rates of lifetime IED (4.2%), suggesting that a lifetime prevalence of IED of 4–6% is not limited to American samples.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> One-month and one-year point prevalences of IED in these studies were reported as 2.0%<sup id="cite_ref-Coccaro2004_35-1" class="reference"><a href="#cite_note-Coccaro2004-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> and 2.7%,<sup id="cite_ref-Kessler2006_8-2" class="reference"><a href="#cite_note-Kessler2006-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> respectively. Extrapolating to the national level, 16.2 million Americans would have IED during their lifetimes and as many as 10.5 million in any year and 6 million in any month. </p><p>Among a <i>clinical</i> population, a 2005 study found the lifetime prevalence of IED to be 6.3%.<sup id="cite_ref-Coccaro2005_37-0" class="reference"><a href="#cite_note-Coccaro2005-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>Prevalence appears to be higher in men than in women.<sup id="cite_ref-Boyd_26-2" class="reference"><a href="#cite_note-Boyd-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p><p>Of US subjects with IED, 67.8% had engaged in direct interpersonal aggression, 20.9% in threatened interpersonal aggression, and 11.4% in aggression against objects. Subjects reported engaging in 27.8 high-severity aggressive acts during their worst year, with 2–3 outbursts requiring medical attention. Across the lifespan, the mean value of property damage due to aggressive outbursts was $1603.<sup id="cite_ref-Kessler2006_8-3" class="reference"><a href="#cite_note-Kessler2006-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>A study in the March 2016 <i>Journal of Clinical Psychiatry</i> suggests a relationship between infection with the parasite <i><a href="/wiki/Toxoplasma_gondii" title="Toxoplasma gondii">Toxoplasma gondii</a></i> and psychiatric aggression such as IED.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Legal_implications">Legal implications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=9" title="Edit section: Legal implications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A diagnosis of EDS has been used as a defense in court for persons accused of committing violent crimes including murder.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=10" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the first edition of the <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a>'s Diagnostic and Statistical Manual (DSM-I), a disorder of impulsive aggression was referred to as a passive-aggressive personality type (aggressive type). This construct was characterized by a "persistent reaction to frustration are "generally excitable, aggressive, and over-responsive to environmental pressures" with "gross outbursts of rage or of verbal or physical aggressiveness different from their usual behavior".<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2020)">citation needed</span></a></i>]</sup> </p><p>In the third edition (DSM-III), this was for the first time codified as intermittent explosive disorder and assigned clinical disorder status under Axis I. However, some researchers saw the criteria as poorly operationalized.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> About 80% of individuals who would now be diagnosed with the disorder would have been excluded.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2020)">citation needed</span></a></i>]</sup> </p><p>In the DSM-IV, the criteria were improved but still lacked objective criteria for the intensity, frequency, and nature of aggressive acts to meet criteria for IED.<sup id="cite_ref-Aboujaoude_23-1" class="reference"><a href="#cite_note-Aboujaoude-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> This led some researchers to adopt alternate criteria set with which to conduct research, known as the IED-IR (Integrated Research). The severity and frequency of aggressive behavior required for the diagnosis were clearly operationalized, the aggressive acts were required to be impulsive in nature, subjective distress was required to precede the explosive outbursts, and the criteria allowed for comorbid diagnoses with <a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">borderline personality disorder</a> and <a href="/wiki/Antisocial_personality_disorder" title="Antisocial personality disorder">antisocial personality disorder</a>.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> These research criteria became the basis for the DSM-5 diagnosis. </p><p>In the current version of the DSM (DSM-5), the disorder appears under the "Disruptive, Impulse-Control, and Conduct Disorders" category. In the DSM-IV, physical aggression was required to meet the criteria for the disorder, but these criteria were modified in the DSM-5 to include verbal aggression and non-destructive/noninjurious physical aggression. The listing was also updated to specify frequency criteria. Further, aggressive outbursts are now required to be impulsive in nature and must cause marked distress, impairment, or negative consequences for the individual. Individuals must be at least six years old to receive the diagnosis. The text also clarified the disorder's relationship to other disorders such as <a href="/wiki/ADHD" class="mw-redirect" title="ADHD">ADHD</a> and <a href="/wiki/Disruptive_mood_dysregulation_disorder" title="Disruptive mood dysregulation disorder">disruptive mood dysregulation disorder</a>.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=11" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Passive%E2%80%93aggressive_personality_disorder" title="Passive–aggressive personality disorder">Passive–aggressive personality disorder</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=12" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFMcTagueAppleton2010" class="citation journal cs1">McTague, A.; Appleton, R. (1 June 2010). "Episodic dyscontrol syndrome". <i>Archives of Disease in Childhood</i>. <b>95</b> (10): 841–842. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fadc.2009.171850">10.1136/adc.2009.171850</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20515972">20515972</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:206845461">206845461</a>. <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><a href="/wiki/ProQuest" title="ProQuest">ProQuest</a> <a rel="nofollow" class="external text" href="https://search.proquest.com/docview/1828696754">1828696754</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Disease+in+Childhood&rft.atitle=Episodic+dyscontrol+syndrome&rft.volume=95&rft.issue=10&rft.pages=841-842&rft.date=2010-06-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A206845461%23id-name%3DS2CID&rft_id=info%3Apmid%2F20515972&rft_id=info%3Adoi%2F10.1136%2Fadc.2009.171850&rft.aulast=McTague&rft.aufirst=A.&rft.au=Appleton%2C+R.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text">Elliott FA. 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"Episodic dyscontrol syndrome". <i>Archives of Disease in Childhood</i>. <b>95</b> (10): 841–842. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fadc.2009.171850">10.1136/adc.2009.171850</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20515972">20515972</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:206845461">206845461</a>. <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><a href="/wiki/ProQuest" title="ProQuest">ProQuest</a> <a rel="nofollow" class="external text" href="https://search.proquest.com/docview/1828696754">1828696754</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Disease+in+Childhood&rft.atitle=Episodic+dyscontrol+syndrome&rft.volume=95&rft.issue=10&rft.pages=841-842&rft.date=2010-06-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A206845461%23id-name%3DS2CID&rft_id=info%3Apmid%2F20515972&rft_id=info%3Adoi%2F10.1136%2Fadc.2009.171850&rft.aulast=McTague&rft.aufirst=A.&rft.au=Appleton%2C+R.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-Coccaro2012-20"><span class="mw-cite-backlink">^ <a href="#cite_ref-Coccaro2012_20-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Coccaro2012_20-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">Coccaro, E.F. (2012). Intermittent explosive disorder as a disorder of impulsive aggression for DSM-5. "American Journal of Psychiatry," 169. 577-588.</span> </li> <li id="cite_note-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-21">^</a></b></span> <span class="reference-text">Coccaro, EF (2000). Intermittent explosive disorder. <i>Current Psychiatry Reports</i>, 2:67-71.</span> </li> <li id="cite_note-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-22">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPuhallaBermanCoccaroFahlgren2020" class="citation journal cs1">Puhalla, Alexander A.; Berman, Mitchell E.; Coccaro, Emil F.; Fahlgren, Martha K.; McCloskey, Michael S. (2020-06-01). <a rel="nofollow" class="external text" href="https://www.sciencedirect.com/science/article/abs/pii/S0022395619310714?via=ihub">"History of childhood abuse and alcohol use disorder: Relationship with intermittent explosive disorder and intoxicated aggression frequency"</a>. <i>Journal of Psychiatric Research</i>. <b>125</b>: 38–44. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jpsychires.2020.02.025">10.1016/j.jpsychires.2020.02.025</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0022-3956">0022-3956</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Psychiatric+Research&rft.atitle=History+of+childhood+abuse+and+alcohol+use+disorder%3A+Relationship+with+intermittent+explosive+disorder+and+intoxicated+aggression+frequency&rft.volume=125&rft.pages=38-44&rft.date=2020-06-01&rft_id=info%3Adoi%2F10.1016%2Fj.jpsychires.2020.02.025&rft.issn=0022-3956&rft.aulast=Puhalla&rft.aufirst=Alexander+A.&rft.au=Berman%2C+Mitchell+E.&rft.au=Coccaro%2C+Emil+F.&rft.au=Fahlgren%2C+Martha+K.&rft.au=McCloskey%2C+Michael+S.&rft_id=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fabs%2Fpii%2FS0022395619310714%3Fvia%3Dihub&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-Aboujaoude-23"><span class="mw-cite-backlink">^ <a href="#cite_ref-Aboujaoude_23-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Aboujaoude_23-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">Aboujaoude, E., & Koran, L. M. (2010). <i>Impulsive control disorders</i>. Cambridge University Press: Cambridge.</span> </li> <li id="cite_note-McCloskey-24"><span class="mw-cite-backlink">^ <a href="#cite_ref-McCloskey_24-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-McCloskey_24-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-McCloskey_24-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text">McCloskey, M.S., Noblett, K.L., Deffenbacher, J.L, Gollan, J.K., Coccaro, E.F. (2008) Cognitive-Behavioral Therapy for Intermittent Explosive Disorder: A Pilot Randomized Clinical Trial. 76(5), 876-886.</span> </li> <li id="cite_note-25"><span class="mw-cite-backlink"><b><a href="#cite_ref-25">^</a></b></span> <span class="reference-text">Goodman, W. K., Ward, H., Kablinger, A., & Murphy, T. (1997). Fluvoxamine in the Treatment of Obsessive-Compulsive Disorder and Related Conditions. J Clin Psychiatry, 58(suppl 5), 32-49.</span> </li> <li id="cite_note-Boyd-26"><span class="mw-cite-backlink">^ <a href="#cite_ref-Boyd_26-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Boyd_26-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Boyd_26-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBoyd,_Mary_Ann2008" class="citation book cs1">Boyd, Mary Ann (2008). <i>Psychiatric nursing: contemporary practice</i>. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. <a rel="nofollow" class="external text" href="https://books.google.com/books?id=L7zqhrxLp3MC&pg=PA820">820–1</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-7817-9169-4" title="Special:BookSources/978-0-7817-9169-4"><bdi>978-0-7817-9169-4</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Psychiatric+nursing%3A+contemporary+practice&rft.place=Philadelphia&rft.pages=820-1&rft.pub=Wolters+Kluwer+Health%2FLippincott+Williams+%26+Wilkins&rft.date=2008&rft.isbn=978-0-7817-9169-4&rft.au=Boyd%2C+Mary+Ann&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-27"><span class="mw-cite-backlink"><b><a href="#cite_ref-27">^</a></b></span> <span class="reference-text">Bozikas, V., Bascilla, F., Yulis, P., & Savvidou, I. (2001). Gabapentin for Behavioral <a href="/wiki/Episodic_dyscontrol_syndrome" class="mw-redirect" title="Episodic dyscontrol syndrome">Dyscontrol</a> with Mental Retardation. <i>Am J Psychiatry</i>, 158(6), 965.</span> </li> <li id="cite_note-28"><span class="mw-cite-backlink"><b><a href="#cite_ref-28">^</a></b></span> <span class="reference-text">Coccaro EF, et al. "A Double-Blind, Randomized, Placebo-Controlled Trial of Fluoxetine in Patients With Intermittent Explosive Disorder," <i>Journal of Clinical Psychiatry</i> (April 21, 2009): Vol. 70, No. 5, pp. 653–62.</span> </li> <li id="cite_note-29"><span class="mw-cite-backlink"><b><a href="#cite_ref-29">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMcTagueAppleton2010" class="citation journal cs1">McTague, A.; Appleton, R. (1 June 2010). "Episodic dyscontrol syndrome". <i>Archives of Disease in Childhood</i>. <b>95</b> (10): 841–842. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fadc.2009.171850">10.1136/adc.2009.171850</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20515972">20515972</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:206845461">206845461</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Disease+in+Childhood&rft.atitle=Episodic+dyscontrol+syndrome&rft.volume=95&rft.issue=10&rft.pages=841-842&rft.date=2010-06-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A206845461%23id-name%3DS2CID&rft_id=info%3Apmid%2F20515972&rft_id=info%3Adoi%2F10.1136%2Fadc.2009.171850&rft.aulast=McTague&rft.aufirst=A.&rft.au=Appleton%2C+R.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-30"><span class="mw-cite-backlink"><b><a href="#cite_ref-30">^</a></b></span> <span class="reference-text">Tunks ER, Dermer SW. (1977) Carbamazepine in the dyscontrol syndrome associated with limbic system dysfunction. Journal of Nervous and Mental Disease 164: 56–63.</span> </li> <li id="cite_note-31"><span class="mw-cite-backlink"><b><a href="#cite_ref-31">^</a></b></span> <span class="reference-text">Lewin J, Sumners D. (1992) Successful treatment of episodic dyscontrol with carbamazepine. British Journal of Psychiatry 161: 261–2.</span> </li> <li id="cite_note-32"><span class="mw-cite-backlink"><b><a href="#cite_ref-32">^</a></b></span> <span class="reference-text">Andrulonis PA, Donnelly J, Glueck BC, Stroebel CF, Szarek BL. (1990) Preliminary data on ethosuximide and the episodic dyscontrol syndrome. American Journal of Psychiatry 137: 1455–6.</span> </li> <li id="cite_note-33"><span class="mw-cite-backlink"><b><a href="#cite_ref-33">^</a></b></span> <span class="reference-text">Grizenko N, Vida S. (1988) Propranolol treatment of episodic dyscontrol and aggressive behaviour in children. Canadian Journal of Psychiatry 33: 776–8.</span> </li> <li id="cite_note-34"><span class="mw-cite-backlink"><b><a href="#cite_ref-34">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMcTagueAppleton2010" class="citation journal cs1">McTague, A.; Appleton, R. (1 June 2010). "Episodic dyscontrol syndrome". <i>Archives of Disease in Childhood</i>. <b>95</b> (10): 841–842. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fadc.2009.171850">10.1136/adc.2009.171850</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20515972">20515972</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:206845461">206845461</a>. <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><a href="/wiki/ProQuest" title="ProQuest">ProQuest</a> <a rel="nofollow" class="external text" href="https://search.proquest.com/docview/1828696754">1828696754</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Disease+in+Childhood&rft.atitle=Episodic+dyscontrol+syndrome&rft.volume=95&rft.issue=10&rft.pages=841-842&rft.date=2010-06-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A206845461%23id-name%3DS2CID&rft_id=info%3Apmid%2F20515972&rft_id=info%3Adoi%2F10.1136%2Fadc.2009.171850&rft.aulast=McTague&rft.aufirst=A.&rft.au=Appleton%2C+R.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-Coccaro2004-35"><span class="mw-cite-backlink">^ <a href="#cite_ref-Coccaro2004_35-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Coccaro2004_35-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">Coccaro EF, Schmidt CA, Samuels JF et al. Lifetime and one-month prevalence rates of intermittent explosive disorder in a community sample. J Clin Psychiatry 65:820–824, 2004.</span> </li> <li id="cite_note-36"><span class="mw-cite-backlink"><b><a href="#cite_ref-36">^</a></b></span> <span class="reference-text">Bromet EJ, Gluzman SF, Paniotto VI et al. Epidemiology of psychiatric and alcohol disorders in Ukraine: Findings from the Ukraine World Mental Health survey. Soc Psychiatry Psychiatr Epidemiol 40:681–690, 2005.</span> </li> <li id="cite_note-Coccaro2005-37"><span class="mw-cite-backlink"><b><a href="#cite_ref-Coccaro2005_37-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCoccaroPosternakZimmerman2005" class="citation journal cs1">Coccaro EF, Posternak MA, Zimmerman M (October 2005). <a rel="nofollow" class="external text" href="http://article.psychiatrist.com/?ContentType=START&ID=10001473">"Prevalence and features of intermittent explosive disorder in a clinical setting"</a>. <i>J Clin Psychiatry</i>. <b>66</b> (10): 1221–7. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4088%2FJCP.v66n1003">10.4088/JCP.v66n1003</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16259534">16259534</a>. <a rel="nofollow" class="external text" href="https://archive.today/20120701120642/http://article.psychiatrist.com/?ContentType=START&ID=10001473">Archived</a> from the original on 2012-07-01.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=J+Clin+Psychiatry&rft.atitle=Prevalence+and+features+of+intermittent+explosive+disorder+in+a+clinical+setting&rft.volume=66&rft.issue=10&rft.pages=1221-7&rft.date=2005-10&rft_id=info%3Adoi%2F10.4088%2FJCP.v66n1003&rft_id=info%3Apmid%2F16259534&rft.aulast=Coccaro&rft.aufirst=EF&rft.au=Posternak%2C+MA&rft.au=Zimmerman%2C+M&rft_id=http%3A%2F%2Farticle.psychiatrist.com%2F%3FContentType%3DSTART%26ID%3D10001473&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-38"><span class="mw-cite-backlink"><b><a href="#cite_ref-38">^</a></b></span> <span class="reference-text">Coccaro EF, Lee R, Groer MW, Can A, Coussons-Read M, Postolache TT (March 2016). <a rel="nofollow" class="external text" href="http://www.psychiatrist.com/jcp/article/Pages/2016/v77n03/v77n0313.aspx">"<i>Toxoplasma gondii</i> Infection: Relationship With Aggression in Psychiatric Subjects"</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160324120448/http://www.psychiatrist.com/JCP/article/Pages/2016/v77n03/v77n0313.aspx">Archived</a> 2016-03-24 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a>. <i><a href="/wiki/J_Clin_Psychiatry" class="mw-redirect" title="J Clin Psychiatry">J Clin Psychiatry</a></i> <b>77</b>(3): 334–341.</span> </li> <li id="cite_note-39"><span class="mw-cite-backlink"><b><a href="#cite_ref-39">^</a></b></span> <span class="reference-text">Myers WC, Vondruska MA. (1998) Murder, minors, selective serotonin reuptake inhibitors, and the involuntary intoxication defence. Journal of the American Academy of Psychiatry and the Law 26: 487–96.</span> </li> <li id="cite_note-40"><span class="mw-cite-backlink"><b><a href="#cite_ref-40">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSimon1990" class="citation book cs1">Simon, Robert I. (1990-12-01). "A Canadian Perspective (p. 392)". <i>Review of Clinical Psychiatry and the Law</i> (Hardback) (Version 2 ed.). Arlington: American Psychiatric Pub, Inc. p. 424. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/0-88048-376-8" title="Special:BookSources/0-88048-376-8"><bdi>0-88048-376-8</bdi></a>. <q>The decision in a case concerning episodic dyscontrol syndrome seems to have expanded the definition of "diseases of the mind". In R. v. Butler, the accused had a history of injuries to the head. He was charged with aggravated assault of his wife's infant son. The child had been badly beaten on the head, and the accused, while admitting that he was alone at home with the child, had no memory of beating the child on the head. The medical history of the accused was brought forward at the trial, and a neurologist ventured the opinion that he sufferred from episodic dyscontrol syndrome, entailing an interruption of normal control mechanisms. His other violent acts were symptomatic. In the court decision, it was noted that disease of the mind had both a legal and medical component.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=A+Canadian+Perspective+%28p.+392%29&rft.btitle=Review+of+Clinical+Psychiatry+and+the+Law&rft.place=Arlington&rft.pages=424&rft.edition=Version+2&rft.pub=American+Psychiatric+Pub%2C+Inc.&rft.date=1990-12-01&rft.isbn=0-88048-376-8&rft.aulast=Simon&rft.aufirst=Robert+I.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-41"><span class="mw-cite-backlink"><b><a href="#cite_ref-41">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTiffanyTiffany,_Mary1990" class="citation book cs1">Tiffany, Lawrence P.; Tiffany, Mary (1990-09-11). <span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/legaldefenseofpa00tiff/page/560">"5"</a></span>. <i>The Legal Defense of Pathological Intoxication </i>With Related Issues of Temporary and Self-Inflicted Insanity<i><span></span></i> (Hardcover). New York: Quorum Books. pp. <a rel="nofollow" class="external text" href="https://archive.org/details/legaldefenseofpa00tiff/page/560">560</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/0-89930-548-2" title="Special:BookSources/0-89930-548-2"><bdi>0-89930-548-2</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=5&rft.btitle=The+Legal+Defense+of+Pathological+Intoxication+With+Related+Issues+of+Temporary+and+Self-Inflicted+Insanity&rft.place=New+York&rft.pages=560&rft.pub=Quorum+Books&rft.date=1990-09-11&rft.isbn=0-89930-548-2&rft.aulast=Tiffany&rft.aufirst=Lawrence+P.&rft.au=Tiffany%2C+Mary&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Flegaldefenseofpa00tiff%2Fpage%2F560&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> <li id="cite_note-42"><span class="mw-cite-backlink"><b><a href="#cite_ref-42">^</a></b></span> <span class="reference-text">Felthous et al., 1991</span> </li> <li id="cite_note-43"><span class="mw-cite-backlink"><b><a href="#cite_ref-43">^</a></b></span> <span class="reference-text">Coccaro et al., 1998</span> </li> <li id="cite_note-44"><span class="mw-cite-backlink"><b><a href="#cite_ref-44">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf">"Highlights of Changes from DSM-IV-TR to DSM-5"</a> <span class="cs1-format">(PDF)</span>. <i>American Psychiatric Association</i>. 2013<span class="reference-accessdate">. Retrieved <span class="nowrap">6 July</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=American+Psychiatric+Association&rft.atitle=Highlights+of+Changes+from+DSM-IV-TR+to+DSM-5&rft.date=2013&rft_id=https%3A%2F%2Fwww.psychiatry.org%2FFile%2520Library%2FPsychiatrists%2FPractice%2FDSM%2FAPA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntermittent+explosive+disorder" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intermittent_explosive_disorder&action=edit&section=13" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output 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dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q18671" class="extiw" title="d:Q18671">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/F63.8">F63.8</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=312.34">312.34</a></li></ul></div></div></td></tr></tbody></table></div> 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style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Adult_personality_and_behavior" style="font-size:114%;margin:0 4em">Adult personality and behavior</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Sexual</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ego-dystonic_sexual_orientation" title="Ego-dystonic sexual orientation">Ego-dystonic sexual orientation</a></li> <li><a href="/wiki/Paraphilia" title="Paraphilia">Paraphilia</a> <ul><li><a href="/wiki/Sexual_fetishism" title="Sexual fetishism">Fetishism</a></li> <li><a href="/wiki/Voyeurism" title="Voyeurism">Voyeurism</a></li></ul></li> <li><a href="/wiki/Sexual_anhedonia" title="Sexual anhedonia">Sexual anhedonia</a></li> <li><a href="/wiki/Sexual_anorexia" title="Sexual anorexia">Sexual anorexia</a></li> <li><a href="/wiki/Sexual_maturation_disorder" title="Sexual maturation disorder">Sexual maturation disorder</a></li> <li><a href="/wiki/Sexual_relationship_disorder" title="Sexual relationship disorder">Sexual relationship disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Factitious_disorder" title="Factitious disorder">Factitious disorder</a> <ul><li><a href="/wiki/Factitious_disorder_imposed_on_self" title="Factitious disorder imposed on self">Munchausen syndrome</a></li></ul></li> <li><a href="/wiki/Fear_of_intimacy" title="Fear of intimacy">Fear of intimacy</a></li> <li><a href="/wiki/Gender_dysphoria" title="Gender dysphoria">Gender dysphoria</a></li> <li><a class="mw-selflink selflink">Intermittent explosive disorder</a></li> <li><a href="/wiki/Excoriation_disorder" title="Excoriation disorder">Dermatillomania</a></li> <li><a href="/wiki/Kleptomania" title="Kleptomania">Kleptomania</a></li> <li><a href="/wiki/Pyromania" title="Pyromania">Pyromania</a></li> <li><a href="/wiki/Trichotillomania" title="Trichotillomania">Trichotillomania</a></li> <li><a href="/wiki/Personality_disorder" title="Personality disorder">Personality disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th 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href="/wiki/Oppositional_defiant_disorder" title="Oppositional defiant disorder">ODD</a></li></ul></li> <li><a href="/wiki/Emotional_and_behavioral_disorders" title="Emotional and behavioral disorders">Emotional and behavioral disorders</a> <ul><li><a href="/wiki/Separation_anxiety_disorder" title="Separation anxiety disorder">Separation anxiety disorder</a></li></ul></li> <li><a href="/wiki/Movement_disorders" class="mw-redirect" title="Movement disorders">Movement disorders</a> <ul><li><a href="/wiki/Stereotypic_movement_disorder" title="Stereotypic movement disorder">Stereotypic</a></li></ul></li> <li>Social functioning <ul><li><a href="/wiki/Disinhibited_attachment_disorder" title="Disinhibited attachment disorder">DAD</a></li> <li><a href="/wiki/Reactive_attachment_disorder" title="Reactive attachment disorder">RAD</a></li> <li><a href="/wiki/Selective_mutism" title="Selective mutism">Selective mutism</a></li></ul></li> <li><a href="/wiki/Speech_disorder" title="Speech disorder">Speech</a> <ul><li><a href="/wiki/Cluttering" title="Cluttering">Cluttering</a></li> <li><a href="/wiki/Stuttering" title="Stuttering">Stuttering</a></li></ul></li> <li><a href="/wiki/Tic_disorder" title="Tic disorder">Tic disorder</a> <ul><li><a href="/wiki/Tourette_syndrome" title="Tourette syndrome">Tourette syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Intellectual_disability" title="Intellectual disability">Intellectual disability</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/X-linked_intellectual_disability" title="X-linked intellectual disability">X-linked intellectual disability</a> <ul><li><a href="/wiki/Lujan%E2%80%93Fryns_syndrome" title="Lujan–Fryns syndrome">Lujan–Fryns syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Psychological development<br />(<a href="/wiki/Developmental_disability" title="Developmental disability">developmental disabilities</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pervasive_developmental_disorder" title="Pervasive developmental disorder">Pervasive</a></li> <li><a href="/wiki/Specific_developmental_disorder" title="Specific developmental disorder">Specific</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Mood_(affective)" style="font-size:114%;margin:0 4em"><a href="/wiki/Mood_disorder" title="Mood disorder">Mood</a> (affective)</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bipolar_disorder" title="Bipolar disorder">Bipolar</a> <ul><li><a href="/wiki/Bipolar_I_disorder" title="Bipolar I disorder">Bipolar I</a></li> <li><a href="/wiki/Bipolar_II_disorder" title="Bipolar II disorder">Bipolar II</a></li> <li><a href="/wiki/Bipolar_disorder_not_otherwise_specified" title="Bipolar disorder not otherwise specified">Bipolar NOS</a></li> <li><a href="/wiki/Cyclothymia" title="Cyclothymia">Cyclothymia</a></li></ul></li> <li><a href="/wiki/Depression_(mood)" title="Depression (mood)">Depression</a> <ul><li><a href="/wiki/Atypical_depression" title="Atypical depression">Atypical depression</a></li> <li><a href="/wiki/Dysthymia" title="Dysthymia">Dysthymia</a></li> <li><a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">Major depressive disorder</a></li> <li><a href="/wiki/Melancholic_depression" class="mw-redirect" title="Melancholic depression">Melancholic depression</a></li> <li><a href="/wiki/Seasonal_affective_disorder" title="Seasonal affective disorder">Seasonal affective disorder</a></li></ul></li> <li><a href="/wiki/Mania" title="Mania">Mania</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Neurological_and_symptomatic" style="font-size:114%;margin:0 4em">Neurological and symptomatic</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Autism_spectrum" class="mw-redirect" title="Autism spectrum">Autism spectrum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Autism" title="Autism">Autism</a></li> <li><a href="/wiki/Asperger_syndrome" title="Asperger syndrome">Asperger syndrome</a></li> <li><a href="/wiki/High-functioning_autism" title="High-functioning autism">High-functioning autism</a></li> <li><a href="/wiki/Pervasive_developmental_disorder_not_otherwise_specified" title="Pervasive developmental disorder not otherwise specified">PDD-NOS</a></li> <li><a href="/wiki/Savant_syndrome" title="Savant syndrome">Savant syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dementia" title="Dementia">Dementia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HIV-associated_neurocognitive_disorder" title="HIV-associated neurocognitive disorder">AIDS dementia complex</a></li> <li><a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a></li> <li><a href="/wiki/Creutzfeldt%E2%80%93Jakob_disease" title="Creutzfeldt–Jakob disease">Creutzfeldt–Jakob disease</a></li> <li><a href="/wiki/Frontotemporal_dementia" title="Frontotemporal dementia">Frontotemporal dementia</a></li> <li><a href="/wiki/Huntington%27s_disease" title="Huntington's disease">Huntington's disease</a></li> <li><a href="/wiki/Mild_cognitive_impairment" title="Mild cognitive impairment">Mild cognitive impairment</a></li> <li><a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">Parkinson's disease</a></li> <li><a href="/wiki/Pick%27s_disease" class="mw-redirect" title="Pick's disease">Pick's disease</a></li> <li><a href="/wiki/Sundowning" title="Sundowning">Sundowning</a></li> <li><a href="/wiki/Vascular_dementia" title="Vascular dementia">Vascular dementia</a></li> <li><a href="/wiki/Wandering_(dementia)" title="Wandering (dementia)">Wandering</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Delirium" title="Delirium">Delirium</a></li> <li><a href="/wiki/Organic_brain_syndrome" title="Organic brain syndrome">Organic brain syndrome</a></li> <li><a href="/wiki/Post-concussion_syndrome" title="Post-concussion syndrome">Post-concussion syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Neurotic,_stress-related_and_somatoform" style="font-size:114%;margin:0 4em"><a href="/wiki/Neurosis" title="Neurosis">Neurotic</a>, <a href="/wiki/Stress_(biology)" title="Stress (biology)">stress</a>-related and <a href="/wiki/Somatic_symptom_disorder" title="Somatic symptom disorder">somatoform</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Adjustment_disorder" title="Adjustment disorder">Adjustment</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adjustment_disorder" title="Adjustment disorder">Adjustment disorder</a> with depressed mood</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anxiety_disorder" title="Anxiety disorder">Anxiety</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Phobia" title="Phobia">Phobia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Agoraphobia" title="Agoraphobia">Agoraphobia</a></li> <li><a href="/wiki/Childhood_phobia" title="Childhood phobia">Childhood phobia</a></li> <li><a href="/wiki/Social_anxiety" title="Social anxiety">Social anxiety</a></li> <li><a href="/wiki/Social_anxiety_disorder" title="Social anxiety disorder">Social phobia</a> <ul><li><a href="/wiki/Anthropophobia" class="mw-redirect" title="Anthropophobia">Anthropophobia</a></li> <li><a href="/wiki/Specific_social_phobia" title="Specific social phobia">Specific social phobia</a></li></ul></li> <li><a href="/wiki/Specific_phobia" title="Specific phobia">Specific phobia</a> <ul><li><a href="/wiki/Claustrophobia" title="Claustrophobia">Claustrophobia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Generalized_anxiety_disorder" title="Generalized anxiety disorder">Generalized anxiety disorder</a></li> <li><a href="/wiki/Obsessive%E2%80%93compulsive_disorder" title="Obsessive–compulsive disorder">OCD</a></li> <li><a href="/wiki/Panic_attack" title="Panic attack">Panic attack</a></li> <li><a href="/wiki/Panic_disorder" title="Panic disorder">Panic disorder</a></li> <li><a href="/wiki/Psychological_stress" title="Psychological stress">Stress</a> <ul><li><a href="/wiki/Acute_stress_reaction" title="Acute stress reaction">Acute stress reaction</a></li> <li><a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">PTSD</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dissociative_disorder" class="mw-redirect" title="Dissociative disorder">Dissociative</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Depersonalization-derealization_disorder" title="Depersonalization-derealization disorder">Depersonalization-derealization disorder</a></li> <li><a href="/wiki/Dissociative_identity_disorder" title="Dissociative identity disorder">Dissociative identity disorder</a></li> <li><a href="/wiki/Dissociative_fugue" title="Dissociative fugue">Dissociative fugue</a></li> <li><a href="/wiki/Psychogenic_amnesia" class="mw-redirect" title="Psychogenic amnesia">Psychogenic amnesia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Somatic_symptom_disorder" title="Somatic symptom disorder">Somatic symptom</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Body_dysmorphic_disorder" title="Body dysmorphic disorder">Body dysmorphic disorder</a></li> <li><a href="/wiki/Conversion_disorder" title="Conversion disorder">Conversion disorder</a> <ul><li><a href="/wiki/Ganser_syndrome" title="Ganser syndrome">Ganser syndrome</a></li> <li><a href="/wiki/Globus_pharyngis" title="Globus pharyngis">Globus pharyngis</a></li> <li><a href="/wiki/Psychogenic_non-epileptic_seizure" title="Psychogenic non-epileptic seizure">Psychogenic non-epileptic seizures</a></li></ul></li> <li><a href="/wiki/False_pregnancy" title="False pregnancy">False pregnancy</a></li> <li><a href="/wiki/Hypochondriasis" title="Hypochondriasis">Hypochondriasis</a></li> <li><a href="/wiki/Mass_psychogenic_illness" title="Mass psychogenic illness">Mass psychogenic illness</a></li> <li><a href="/wiki/Nosophobia" title="Nosophobia">Nosophobia</a></li> <li><a href="/wiki/Psychogenic_pain" title="Psychogenic pain">Psychogenic pain</a></li> <li><a href="/wiki/Somatization_disorder" class="mw-redirect" title="Somatization disorder">Somatization disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Physiological_and_physical_behavior" style="font-size:114%;margin:0 4em">Physiological and physical behavior</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eating_disorder" title="Eating disorder">Eating</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anorexia_nervosa" title="Anorexia nervosa">Anorexia nervosa</a></li> <li><a href="/wiki/Bulimia_nervosa" title="Bulimia nervosa">Bulimia nervosa</a></li> <li><a href="/wiki/Rumination_syndrome" title="Rumination syndrome">Rumination syndrome</a></li> <li><a href="/wiki/Other_specified_feeding_or_eating_disorder" title="Other specified feeding or eating disorder">Other specified feeding or eating disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Nonorganic <a href="/wiki/Sleep_disorder" title="Sleep disorder">sleep</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersomnia" title="Hypersomnia">Hypersomnia</a></li> <li><a href="/wiki/Insomnia" title="Insomnia">Insomnia</a></li> <li><a href="/wiki/Parasomnia" title="Parasomnia">Parasomnia</a> <ul><li><a href="/wiki/Night_terror" title="Night terror">Night terror</a></li> <li><a href="/wiki/Nightmare" title="Nightmare">Nightmare</a></li> <li><a href="/wiki/Rapid_eye_movement_sleep_behavior_disorder" title="Rapid eye movement sleep behavior disorder">REM sleep behavior disorder</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Psychiatric_disorders_of_childbirth" title="Psychiatric disorders of childbirth">Postnatal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Postpartum_depression" title="Postpartum depression">Postpartum depression</a></li> <li><a href="/wiki/Postpartum_psychosis" title="Postpartum psychosis">Postpartum psychosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sexual_dysfunction#Sexual_desire_disorders" title="Sexual dysfunction">Sexual desire</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersexuality" title="Hypersexuality">Hypersexuality</a></li> <li><a href="/wiki/Hypoactive_sexual_desire_disorder" title="Hypoactive sexual desire disorder">Hypoactive sexual desire disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Psychoactive_substances,_substance_abuse_and_substance-related" style="font-size:114%;margin:0 4em"><a href="/wiki/Psychoactive_drug" title="Psychoactive drug">Psychoactive</a> substances, <a href="/wiki/Substance_abuse" title="Substance abuse">substance abuse</a> and substance-related</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drug_overdose" title="Drug overdose">Drug overdose</a></li> <li><a href="/wiki/Substance_intoxication" title="Substance intoxication">Intoxication</a></li> <li><a href="/wiki/Physical_dependence" title="Physical dependence">Physical dependence</a></li> <li><a href="/wiki/Rebound_effect" title="Rebound effect">Rebound effect</a></li> <li><a href="/wiki/Stimulant_psychosis" title="Stimulant psychosis">Stimulant psychosis</a></li> <li><a href="/wiki/Substance_dependence" title="Substance dependence">Substance dependence</a></li> <li><a href="/wiki/Drug_withdrawal" title="Drug withdrawal">Withdrawal</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Schizophrenia,_schizotypal_and_delusional" style="font-size:114%;margin:0 4em"><a href="/wiki/Schizophrenia" title="Schizophrenia">Schizophrenia</a>, <a href="/wiki/Schizotypal_personality_disorder" title="Schizotypal personality disorder">schizotypal</a> and <a href="/wiki/Delusional_disorder" title="Delusional disorder">delusional</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Delusional</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Delusional_disorder" title="Delusional disorder">Delusional disorder</a></li> <li><a href="/wiki/Folie_%C3%A0_deux" title="Folie à deux">Folie à deux</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Psychosis" title="Psychosis">Psychosis</a> and<br />schizophrenia-like</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brief_reactive_psychosis" class="mw-redirect" title="Brief reactive psychosis">Brief reactive psychosis</a></li> <li><a href="/wiki/Schizoaffective_disorder" title="Schizoaffective disorder">Schizoaffective disorder</a></li> <li><a href="/wiki/Schizophreniform_disorder" title="Schizophreniform disorder">Schizophreniform disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Schizophrenia</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Childhood_schizophrenia" title="Childhood schizophrenia">Childhood schizophrenia</a></li> <li><a href="/wiki/Disorganized_schizophrenia" title="Disorganized schizophrenia">Disorganized (hebephrenic) schizophrenia</a></li> <li><a href="/wiki/Pseudoneurotic_schizophrenia" title="Pseudoneurotic schizophrenia">Pseudoneurotic schizophrenia</a></li> <li><a href="/wiki/Simple-type_schizophrenia" title="Simple-type schizophrenia">Simple-type schizophrenia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Catatonia" title="Catatonia">Catatonia</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible uncollapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Symptoms_and_uncategorized" style="font-size:114%;margin:0 4em">Symptoms and uncategorized</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Impulse-control_disorder" title="Impulse-control disorder">Impulse-control disorder</a></li> <li><a href="/wiki/Kl%C3%BCver%E2%80%93Bucy_syndrome" title="Klüver–Bucy syndrome">Klüver–Bucy syndrome</a></li> <li><a href="/wiki/Psychomotor_agitation" title="Psychomotor agitation">Psychomotor agitation</a></li> <li><a href="/wiki/Stereotypy" title="Stereotypy">Stereotypy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Intermittent_explosive_disorder&oldid=1258629423">https://en.wikipedia.org/w/index.php?title=Intermittent_explosive_disorder&oldid=1258629423</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Impulse-control_disorders" title="Category:Impulse-control disorders">Impulse-control disorders</a></li><li><a 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