Definitions of impulse control disorders

Historically, impulse control disorders have been defined as harmful behaviours performed in response to irresistible impulses. (1.) In DSM-IV, an impulse control disorder is defined as the failure to resist an impulse, drive, or temptation to commit an act that is harmful to the individual or to others. (2.,3) DSM-IV also stipulates that for most impulse control disorders, the individual feels an increasing sense of tension or arousal before committing the act and then experiences pleasure, gratification, or relief at the time of committing the act. In the text describing these disorders, DSM-IV states that after the act, there may or may not be genuine regret, self-reproach, or guilt. In ICD-10,(4.) these conditions are classified as habit and impulse disorders and defined as repeated acts that have no clear rational motivation that generally harm the patient's own interests and those of other people. ICD-10 further states that the behaviours are associated with impulses to action that cannot be controlled.

In DSM-IV, impulse control disorders are listed in a residual category, 'Impulse control disorders not elsewhere classified', which includes intermittent explosive disorder, kleptomania, pathological gambling, pyromania, trichotillomania, and impulse control disorders not otherwise specified. Examples of impulse control disorders not otherwise specified are compulsive buying or shopping (also called buying mania or oniomania), repetitive self-mutilation, psychogenic excoriation (also called compulsive skin picking), and onychophagia (severe nail-biting). (1> In ICD-10, habit and impulse disorders are also listed as a residual category. Similar to DSM-IV, it includes pathological gambling, pathological fire-setting (pyromania), pathological stealing (kleptomania), trichotillomania, other habit and impulse disorders (which includes intermittent explosive (behaviour) disorder), and habit and impulse disorder, unspecified.

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