Category: Dissociative disorders

Intermittent Explosive Disorder

Learn About Intermittent Explosive Disorder

Intermittent explosive disorder (IED) is an impulse-control disorder characterized by sudden episodes of unwarranted anger. The disorder is typified by hostility, impulsivity, and recurrent aggressive outbursts. People with IED essentially “explode” into a rage despite a lack of apparent provocation or reason. Individuals suffering from intermittent explosive disorder have described feeling as though they lose control of their emotions and become overcome with anger. People with IED may threaten to or actually attack objects, animals, and/or other humans. IED is said to typically begin during the early teen years and evidence has suggested that it has the potential of predisposing individuals to depression, anxiety, and substance abuse disorders. Intermittent explosive disorder is not diagnosed unless a person has displayed at least three episodes of impulsive aggressiveness.

Individuals with IED have reported that once they have released the tension that built up as a result of their rage, they feel a sense of relief. Once the relief wears off, however, some people report experiencing feelings of remorse or embarrassment. While IED can be extremely disruptive to an individual’s life, as well as to the lives of those around him or her, IED can be managed through proper treatment, through education about anger management, and possibly through the use of medication.

Signs and Symptoms of Intermittent Explosive Disorder

There are a variety of symptoms that people who have intermittent explosive disorder will display based upon individual genetic makeup, development of social skills, coping strategies, presence of co-occurring disorders, and use or addiction to drugs or alcohol. The following are some examples of various signs and symptoms that a person suffering from IED may exhibit:

Behavioral symptoms:

  • Physical aggressiveness
  • Verbal aggressiveness
  • Angry outbursts
  • Physically attacking people and/or objects
  • Damaging property
  • Road rage

Physical symptoms:

  • Headaches
  • Muscle tension
  • Chest tightness
  • Palpitations
  • Tingling
  • Feelings of pressure in the head
  • Tremors

Cognitive symptoms:

  • Low frustration tolerance
  • Feeling a loss of control over one’s thoughts
  • Racing thoughts

Psychosocial symptoms:

  • Feelings of rage
  • Uncontrollable irritability
  • Brief periods of emotional detachment    more

Functional neurologic disorder/conversion disorder

Overview

Functional neurologic disorder — a newer and broader term that includes what some people call conversion disorder — features nervous system (neurological) symptoms that can’t be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning.

Signs and symptoms vary, depending on the type of functional neurologic disorder, and may include specific patterns. Typically, this disorder affects your movement or your senses, such as the ability to walk, swallow, see or hear. Symptoms can vary in severity and may come and go or be persistent. However, you can’t intentionally produce or control your symptoms.

The cause of functional neurologic disorder is unknown. The condition may be triggered by a neurological disorder or by a reaction to stress or psychological or physical trauma, but that’s not always the case. Functional neurologic disorder is related to how the brain functions, rather than damage to the brain’s structure (such as from a stroke, multiple sclerosis, infection or injury).

Early diagnosis and treatment, especially education about the condition, can help with recovery.

 

Symptoms

Signs and symptoms of functional neurologic disorder may vary, depending on the type of functional neurological symptoms, and they’re significant enough to cause impairment and warrant medical evaluation. Symptoms can affect body movement and function and the senses.

Signs and symptoms that affect body movement and function may include:

  • Weakness or paralysis
  • Abnormal movement, such as tremors or difficulty walking
  • Loss of balance
  • Difficulty swallowing or feeling “a lump in the throat”
  • Seizures or episodes of shaking and apparent loss of consciousness (nonepileptic seizures)
  • Episodes of unresponsiveness

Signs and symptoms that affect the senses may include:

  • Numbness or loss of the touch sensation
  • Speech problems, such as the inability to speak or slurred speech
  • Vision problems, such as double vision or blindness
  • Hearing problems or deafness
  • Cognitive difficulties involving memory and concentration    more

Brief Psychotic Disorder

Brief psychotic disorder (BPD) according to DSM-5 is the sudden onset of psychotic behavior that lasts less than 1 month followed by complete remission with possible future relapses. It is differentiated from schizophreniform disorder and schizophrenia by the duration of the psychosis. The diagnosis is often anticipatory or retrospective due to the diagnostic requirement of complete remission within 1 month.

Brief psychotic disorder is an acute but transient disorder with the onset of one or more of the following psychotic symptoms:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior

At least one of these symptoms must be delusions, hallucinations, or disorganized speech. The symptoms in BPD last between one day to one month, with a complete return to premorbid level of functioning after the disease course in response to antipsychotic medications. The disturbance in behavior cannot be better accounted for by schizophrenia, schizoaffective disorder, mood disorder with psychotic features, or be a direct result of a drug, medication, or medical condition like thyrotoxicosis, sarcoidosis, or syphilis.

Etiology

Although unclear, the underlying etiology of brief psychotic disorder can be a stressful event or trauma. There may be a genetic, neurological, or environmental component to BPD as well. The specific trigger of BPD, if present, must be specified as follows:

  • Brief psychotic disorder with marked stressor(s) is also referred to as brief reactive psychosis. It is the onset of psychotic symptoms that occur in response to a traumatic event that would be stressful for anyone in similar circumstances in the same culture
  • Brief psychotic disorder without marked stressor(s) is the onset of psychotic symptoms that occur in the absence of a traumatic event that would be stressful for anyone in similar circumstances in the same culture
  • Brief psychotic disorder with postpartum onset is defined as the onset of psychotic symptoms that occur within four weeks postpartum   more

Catatonic Schizophrenia

Catatonic schizophrenia is a subtype of schizophrenia that experts now consider obsolete. Experts no longer recognize it as a specific condition, and instead, attach catatonia as an additional feature when diagnosing schizophrenia. Catatonia is sometimes dangerous, but is usually very treatable with medication or other methods.

What is catatonic schizophrenia?

“Catatonic schizophrenia” is a subtype of schizophrenia that includes catatonia as a key feature. Experts no longer recognize it as a diagnosis, making this name obsolete. Today, experts recognize schizophrenia as a specific disease and a spectrum of disorders. Healthcare providers regard catatonia as an important syndrome to consider and treat, especially when it happens with schizophrenia.

The American Psychiatric Association removed catatonic schizophrenia from its list of official diagnoses when updating to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013. The World Health Organization (WHO) removed “catatonic schizophrenia” from the International Classification of Diseases when updating to the 11th edition (ICD-11) in 2019.

What is catatonia?

Catatonia is a syndrome — a collection of signs and symptoms — where your brain doesn’t manage muscle movement signals as it should and you behave abnormally. It happens with many other conditions, but schizophrenia is frequently associated with catatonia. Once thought to be the only condition associated with catatonia, it’s now known that bipolar disorder is more commonly associated with catatonia and that catatonia occurs alongside a number of medical and mental health conditions.

There are three main forms of catatonia: excited, withdrawn and mixed.

  • Excited/hyperkinetic: This form involves increased movement (such as in the form of pacing), agitated behavior, unusual or exaggerated movements, repetitive movements or speaking, or mimicking someone speaking or moving near them.
  • Withdrawn/hypokinetic: This form of catatonia is often easier to spot because people with this form of catatonia have very limited responses — or no response at all — to what’s happening around them. They may be mute, show no emotions or facial expressions, hold completely still or stare or stay in an unusual position for an extended period.
  • Mixed: This form combines features of hyperkinetic and hypokinetic catatonia.

What is the difference between catatonic schizophrenia and paranoid schizophrenia?

Like “catatonic schizophrenia,” “paranoid schizophrenia” is an obsolete term for a diagnosis that no longer exists. Paranoid schizophrenia was the name for schizophrenia where experts regarded paranoia, delusions and hallucinations as key symptoms. Catatonic schizophrenia is the term for schizophrenia where catatonia is the most dominant feature.   more

Intermittent explosive disorder (IED)

Overview

Intermittent explosive disorder involves repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may be signs of intermittent explosive disorder.

These intermittent, explosive outbursts cause you significant distress, negatively impact your relationships, work and school, and they can have legal and financial consequences.

Intermittent explosive disorder is a chronic disorder that can continue for years, although the severity of outbursts may decrease with age. Treatment involves medications and psychotherapy to help you control your aggressive impulses.

 

Symptoms

Explosive eruptions occur suddenly, with little or no warning, and usually last less than 30 minutes. These episodes may occur frequently or be separated by weeks or months of nonaggression. Less severe verbal outbursts may occur in between episodes of physical aggression. You may be irritable, impulsive, aggressive or chronically angry most of the time.

Aggressive episodes may be preceded or accompanied by:

  • Rage
  • Irritability
  • Increased energy
  • Racing thoughts
  • Tingling
  • Tremors
  • Palpitations
  • Chest tightness

The explosive verbal and behavioral outbursts are out of proportion to the situation, with no thought to consequences, and can include:

  • Temper tantrums
  • Tirades
  • Heated arguments
  • Shouting
  • Slapping, shoving or pushing
  • Physical fights
  • Property damage
  • Threatening or assaulting people or animals

You may feel a sense of relief and tiredness after the episode. Later, you may feel remorse, regret or embarrassment.   more