Intermittent explosive disorder

Intermittent explosive disorder
Other namesEpisodic dyscontrol syndrome (EDS), dyscontrol
Cartoon of Christina Rossetti in a fit of anger, drawn by her brother Dante (1862).
SpecialtyPsychiatry
SymptomsExplosive outbursts of anger or violence, often to the point of rage, that are disproportionate to the situation at hand
Differential diagnosisAlcoholism, post-traumatic stress disorder, bipolar disorder, antisocial personality disorder
TreatmentCognitive behavioral therapy, medication
Frequency3%

Intermittent explosive disorder (IED), or episodic dyscontrol syndrome (EDS), is a mental disorder characterized by explosive outbursts of anger or violence, often to the point of rage, that are disproportionate to the situation (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, that would often be associated with a choleric temperament. Some individuals have reported affective changes prior to an outburst, such as tension, mood changes, and energy changes.

The disorder is currently categorized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the "Disruptive, Impulse-Control, and Conduct Disorders" category. The disorder itself is not easily characterized and often exhibits comorbidity with other mood disorders, particularly bipolar disorder. 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, palpitations) reported by a third of one sample. Aggressive acts are frequently reported to be accompanied by a sensation of relief and, in some cases, pleasure, but often followed by later remorse. Individuals with IED can experience different challenges depending on the severity and type of personality traits they have.