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Tests and diagnosis
By Mayo Clinic staffTo be diagnosed with intermittent explosive disorder, your doctor will ask you about your behavior to see if you meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for intermittent explosive disorder. This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
DSM criteria include:
- Multiple incidents in which the person failed to resist aggressive impulses that resulted in deliberate destruction of property or assault of another person.
- The degree of aggressiveness expressed during the incidents is completely out of proportion with the precipitating event.
- The aggressive episodes aren't accounted for by another mental disorder and are not due to the effects of a drug or a general medical condition.
Other conditions that must be ruled out before making a diagnosis of intermittent explosive disorder include delirium, dementia, borderline personality disorder, antisocial personality disorder, schizophrenia, a manic episode, substance abuse or withdrawal, head trauma, seizures, or intoxication.
People with intermittent explosive disorder may also show some minor irregularities in neurological signs and electroencephalograms (EEGs). An EEG is a noninvasive test that measures the electrical activity in your brain.
- Thompson JW Jr, et al. Impulse-control disorders. In: Ebert MH, et al. Current Diagnosis and Treatment: Psychiatry. 2nd ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=3289149. Accessed March 6, 2010.
- Intermittent explosive disorder. In: Sadock BJ, et al. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. Philadelphia, Pa.: Lippincott, Williams and Wilkins; 2005. http://ovidsp.tx.ovid.com/sp-2.3/ovidweb.cgi?&S=LIGLFPOGPNDDKGHDNCELCBCKMEKJAA00&Link+Set=S.sh.16%7c5%7csl_10. Accessed March 8, 2010.
- Kessler RC. The prevalence and correlates of DSM-IV intermittent explosive disorder in the national comorbidity survey replication. Archives of General Psychiatry. 2006:63;669.
- Intermittent explosive disorder. In: Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa.: Mosby Elsevier; 2008. http://www.mdconsult.com/das/book/body/187865115-2/0/1657/221.html?tocnode=57542767&fromURL=221.html#4-u1.0-B978-0-323-04743-2..50025-1--cesec2_542. Accessed March 6, 2010.
- Kessler RC, et al. Intermittent explosive disorder is common, has an early age of onset and is associated with the development of other mental disorders in the US population. Evidence Based Mental Health. 2007;10:32.
- McCloskey MS, et al. Prevalence of suicidal and self-injurious behavior among subjects with intermittent explosive disorder. Psychiatry Research. 2008;158:248.
- Koelsch S, et al. EEG correlates of moderate intermittent explosive disorder. Clinical Neurophysiology. 2008;119:151.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. March 9, 2010.
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