Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, or an impulse; or having the inability to not speak on a thought. The fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that was published in 2013 includes a new chapter on disruptive, impulse-control, and conduct disorders covering disorders "characterized by problems in emotional and behavioral self-control". The World Health Organization publishes a similar list of impulse control disorders in its International Classification of Diseases (ICD), with some overlaps and differences. Five behavioral stages characterize impulsivity: an impulse, growing tension, pleasure on acting, relief from the urge, and finally guilt (which may or may not arise).
DSM-5 Types The DSM-5 lists several disorders in its Disruptive, Impulse-Control, and Conduct Disorders chapter, without further specifying which of those categories each disorder may belong to. Trichotillomania (hair-pulling) and skin-picking were moved in DSM-5 to the obsessive–compulsive chapter, and "pathological gambling" was replaced with "gambling disorder" in the addictive disorders section. Many other DSM-5 disorders may include difficulties in self-control of behavior. The ones in this chapter of the DSM-5 generally involve actions that violate others' rights, or cause conflicts with social norms, authorities, or laws. The underlying causes may be different in each disorder or each individual. Several other new classifications were proposed prior to the publication of the DSM-5. Among those were compulsive–impulsive (C–I) Internet usage disorder, C–I sexual behaviors, C–I skin picking and C–I shopping. They were ultimately not included in those forms. The DSM-5 states that there is insufficient evidence to produce diagnostic criteria needed to establish repetitive behavior patterns sometimes called sex addiction, exercise addiction, or shopping addiction, as mental disorders, and thus they are not included, either as impulse control disorders or addictions.
Oppositional defiant disorder
Intermittent explosive disorder
Intermittent explosive disorder (IED) is a clinical condition of experiencing recurrent aggressive episodes that are out of proportion of any given stressor. Earlier studies reported a prevalence rate between 1–2% in a clinical setting, but a study done by Coccaro and colleagues in 2004 had reported about 11.1% lifetime prevalence and 3.2% one month prevalence in a sample of a moderate number of individuals (n=253). Based on the study, Coccaro and colleagues estimated the prevalence of IED in 1.4 million individuals in the US and 10 million with lifetime IED.
Conduct disorder
Antisocial personality disorder
This personality disorder is also dual coded in this chapter, because it is closely connected to the range of "externalizing" impulse control disorders.
Pyromania
Pyromania is characterized by impulsive and repetitive urges to deliberately start fires. Because of its nature, the number of studies performed for fire-setting are understandably limited. However, studies done on children and adolescents with pyromania have reported its prevalence to be between 2.4 and 3.5% in the United States. It has also been observed that the incidence of fire-setting is more common in juvenile and teenage boys than girls of the same age.
Kleptomania
Kleptomania is characterized by an impulsive urge to steal purely for the sake of gratification. In the US, the presence of kleptomania is unknown but has been estimated at 6 per 1000 individuals. Kleptomania is also thought to be the cause of 5% of annual shoplifting in the U.S. If true, 100,000 arrests are made in the U.S. annually due to kleptomaniac behavior.
ICD-11 types In common with the DSM-5, the World Health Organization's ICD-11 includes pyromania, kleptomania, and intermittent explosive disorder as impulse control disorders. Oppositional defiant disorder and conduct-dissocial disorder are instead listed under "disruptive behaviour or dissocial disorders". In contrast, it also includes several other disorders such as compulsive sexual behavior disorder, substance-induced impulse control disorders, gambling disorder, gaming disorder, body-focused repetitive behavior disorders (hair pulling, skin picking, etc.) and compulsive buying–shopping disorder, as forms of impulse control disorders.
Compulsive sexual behavior disorder
Sexual compulsion includes an increased urge in sexual behavior and thoughts. This compulsion may also lead to several consequences in the individual's life, including risky partner selection, increased chance for STIs and depression, as well as unwanted pregnancy. There has not yet been a determined estimate of its prevalence due to the secretiveness of the disorder. However, research conducted in the early 1990s in the United States gave prevalence estimates between 5–6% in the U.S. population, with male cases being higher than female.
Compulsive buying–shopping disorder
Compulsive shopping or buying is characterized by a frequent irresistible urge to shop even if the purchases are not needed or cannot be afforded. The prevalence of compulsive buying in the U.S. has been estimated to be 2–8% of the general adult population, with 80–95% of these cases being females. The onset is believed to occur in late teens or early twenties and the disorder is considered to be generally chronic.
Signs and symptoms The signs and symptoms of impulse-control disorders vary based on the age of the persons with them, the actual type of impulse-control that they are struggling with, the environment in which they are living, and whether they are male or female.
Co-morbidity
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