Impulse Control Disorders

Definition

Impulse control disorders (ICDs) are extreme urges and failure to resist acting on them.

ICDs can involve:

• Outbursts of physical or verbal rage—intermittent explosive disorder
• Oppositional defiant disorder (ODD)
• Conduct disorder (CD)
• Stealing—kleptomania
• Setting fires—pyromania
• Uncontrolled use of the Internet, which may serve as an outlet for other ICDs

ICDs can make daily life difficult. They cause problems with school, work, and relationships. They often involve problems with money and the law.

Causes

The cause of ICDs is unknown. It may be caused by changes in an area of the brain called the frontal lobe. The frontal lobe of the brain controls impulses.

The Brain.

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Risk Factors

ICD is more common in those who:

• Have other mental health problem such as bipolar disorder or obsessive-compulsive disorder
• Have substance misuse problem or problems in the family
• Have family history of ICD
• Have Tourette syndrome
• Have family problems such as fighting or abuse
• Use some medicine to treat Parkinson disease
• Have late stage Parkinson disease

Symptoms

ICDs can start at any age. Many start during childhood or the teenage years. Symptoms are based on the type of ICD.

Symptoms of ICDs may be:

• Injuries from fights or burns from starting fires
• Lying or stealing
• Irritability, impatience, or anger
• Problems with family, partners, or spouses
• Repeated problems with people, school, or work
• Problems with money or the law, which may involve being arrested

People with ICDs tend to feel:

• Growing tension before the act
• Pleasure or euphoria during the act
• Relief after the act—there may or may not be feelings of guilt or distress

Diagnosis

The doctor will ask about symptoms and past health. Questions may be asked about problems and mental health concerns. It is important to be open and honest with the doctor. The answers can help to make a diagnosis and guide treatment.

Treatment

Treatment can help to manage symptoms. The exact plan will be based on individual needs. Steps may include:

• Medicine—to ease symptoms. Treatment may include more than one type of medicine. It may take some time to find the right mix of medicine.
• Therapy may be done alone or in a group. It will help to cope with problems linked to ICD. Medicine may also ease reaction to urges. There are many types of therapy. Cognitive behavioral therapy (CBT) and family therapy are some options that may be used for ICD.

Prevention

There are no guidelines to prevent ICDs.