Intermittent explosive disorder
ICD-10 F63.81 is a billable code used to indicate a diagnosis of intermittent explosive disorder.
Intermittent Explosive Disorder (IED) is characterized by recurrent episodes of impulsive, aggressive, violent behavior and angry verbal outbursts, often disproportionate to the provocation or any identifiable stressors. These episodes can result in physical harm to others or destruction of property. The disorder typically manifests in late childhood or adolescence and can persist into adulthood. Individuals with IED may experience a sense of tension or arousal before the outburst, followed by relief or gratification after the aggressive act. The impulsivity associated with IED is distinct from other impulse control disorders, as it is marked by a lack of forethought and planning. The diagnosis requires that the aggressive outbursts are not better explained by another mental disorder, such as a personality disorder or substance use disorder. Gender differences in prevalence have been noted, with males often exhibiting more severe symptoms. Treatment options include psychotherapy, cognitive-behavioral therapy, and pharmacotherapy, focusing on impulse control and emotional regulation.
Detailed patient history, including frequency and context of aggressive outbursts, and any co-occurring disorders.
Patients presenting with aggressive behavior in outpatient settings, or those with a history of violence.
Consideration of comorbid conditions such as anxiety or mood disorders that may complicate the diagnosis.
Comprehensive psychological evaluations and behavioral assessments.
Patients undergoing therapy for anger management or those referred for behavioral issues in school settings.
Focus on behavioral triggers and coping strategies in therapy sessions.
Used for therapy sessions focusing on anger management strategies.
Document the focus of therapy and progress made.
Psychiatrists may need to provide additional context regarding the patient's history.
The primary symptoms include recurrent aggressive outbursts, impulsive behavior, and a sense of tension before the outburst, followed by relief after the aggressive act.
