Impulse Control Disorders: Intermittent Explosive Disorder, Kleptomania and Pyromania

Although dissimilar in behavioral expressions, the disorders in this chapter share the feature of impulse dyscontrol. Whereas impulse control disorders were once conceptualized as either addictive or compulsive behaviors, in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, impulsive behavior is recognized as an important feature in numerous psychiatric diagnoses. Those not classified and described elsewhere are grouped together in the chapter disruptive, impulse control, and conduct disorders. Included in this chapter are intermittent explosive disorder (failure to resist aggressive impulses), kleptomania (failure to resist urges to steal items), and pyromania (failure to resist urges to set fires). It was noted, as is still the case in DSM-5, that behaviors characteristic of these disorders may be present in individuals as symptoms of another mental disorder. If the symptoms progress to such a point that they occur in distinct, frequent episodes and begin to interfere with the person’s normal functioning, they may then be classified as a distinct impulse control disorder. The International Statistical Classification of Diseases and Related Health Problems, 11th edition (ICD-11) introduced intermittent explosive disorder as a new classification under the “impulse control disorders” grouping which also includes kleptomania and pyromania.