Intermittent Explosive Disorder Definition/Description A condition characterised by outburst or impulsive aggression (verbal or physical) that are intermittent, unplanned, and out of proportion to the circumstances, causing the individual significant distress and impairing psychological functioning. Epidemiology • • More common in men More common onset at 14 to 17. Aetiology • • • • • Genetics Neurobiological Inflammatory Infectious e.g. toxoplasma gondii Psychological and/or social factors e.g. history of abuse Diagnosis DSM V A. Recurrent behavioural outbursts representing a failure to control aggressive impulses as manifested by either of the following: 1. Verbal aggression or physical aggression toward property, animals, or other individuals, occurring twice weekly, on average, for a period of 3 months. The physical aggression does not result in damage or destruction of property and does not result in physical injury to animals or other individuals. 2. Three behavioural outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals occurring within a 12-month period. B. The magnitude of aggressiveness expressed during the recurrent outbursts is grossly out of proportion to the provocation or to any precipitating psychosocial stressors. C. The recurrent aggressive outbursts are not premeditated (i.e., they are impulsive and/or anger-based) and are not committed to achieve some tangible objective (e.g., money, power, intimidation). D. The recurrent aggressive outbursts cause either marked distress in the individual or impairment in occupational or interpersonal functioning, or are associated with financial or legal consequences. E. Chronological age is at least 6 years (or equivalent developmental level). F. The recurrent aggressive outbursts are not better explained by another mental disorder Treatment and Management • • • CBT Pharmacotherapy: - SSRIs - Mood stabilizers - Anxiety meds - Antipsychotics Lifestyle - Balanced diet - Getting enough sleep - Staying physically active - Avoiding alcohol, drugs and cigarettes - Reducing and managing sources of stress - Making time for relaxing and leisure activities - Practicing medications and other mindfulness techniques - Trying alternative therapies such as acupressure, acupuncture or message