Impuse Control

Pyromania

Impulse to start fires for no other reason than to relieve tension; the patient often experiences tension or arousal prior to the act.

Patients have no secondary intention by starting the fire (e.g. political motivation, hallucination, etc.).,

Intermittent explosive disorder

Intermittent explosive disorder is characterized by recurrent outbursts of aggression/anger that are out of proportion to the triggering event.,

According to one set of criteria, intermittent explosive disorder can be diagnosed in a patient who has behavioral outbursts that do not result in damage of property or physical injury to animals or other individuals if these outbursts occur at least two times per week for a period of three months.

Low levels of serotonin, particularly in the limbic system, are associated with intermittent explosive disorder.

Serotonin acts in the prefrontal cortex and assists in the suppression of aggressive behaviors. A deficiency of serotonin can contribute to disinhibition of aggression and can thus contribute to the type of outbursts seen in patients with intermittent explosive disorder. Decreased levels of serotonin are also seen in patients with clinical anxiety, depression, and Parkinson disease.

Kleptomania

Characterized by uncontrollable urges to steal objects. Stolen objects are not needed and are often given away or returned. The act of stealing is preceded by a feeling of tension which is relieved by the act, but then followed by shame or guilt.,

About 25% of patients with bulimia nervosa have comorbid kleptomania.

Treatment

The best treatment for impulse control disorders (pyromania, intermittent explosive, kleptomania) is CBT. SSRI's, mood stablizers, and other pharmacological agents can be used to address symptoms or comorbid disorders.

Impulse control disorders are frequently comorbid with substance abuse, other impulse control disorders, and depression.