Intermittent explosive disorder is a disorder characterized by recurrent, impulsive aggressive outbursts that are disproportionate to the situation. These episodes have a rapid onset, typically last under 30 minutes, and occur in response to provocation.
Diagnostic Features:
1.Aggressive outbursts occur suddenly, without premeditation, and usually in response to provocation.
2.Episodes vary in severity, with verbal or non injurious physical aggression interspersed with more severe incidents.
3.Aggression is impulsive and excessive in response to a psychosocial stressor.
4.Outbursts cause distress or impairment in social, occupational, or legal aspects.
5.Diagnosis applies to individuals over 6 years old (or an equivalent developmental level).
6.Aggression is not better explained by other disorders, medical conditions, or substance use.
Differential Diagnosis:
IED should not be diagnosed if symptoms are better explained by disorders like ADHD, conduct disorder, oppositional defiant disorder, autism spectrum disorder, borderline personality disorder, or antisocial personality disorder.
However, if aggressive outbursts exceed what is typical in these conditions, IED may be diagnosed alongside them.
Epidemiology & Comorbidities:
Onset typically occurs between ages 12–21.
More common in males.
High comorbidity (81%) with disorders such as substance use disorders, PTSD, anxiety, depression, borderline personality disorder, and antisocial personality disorder.
Increased risk of self-harm and emotion regulation difficulties.