Insight into impulse control disorders

IMPULSE control disorders are a loosely grouped set of conditions whose central feature is a behaviour that is acted out in an uncontrolled and impulsive manner that often has self-destructive consequences. The following is a list of common impulse control disorders: Intermittent Explosive Disorder Kleptomania Pyromania Pathological Gambling Trichotillomania: Characterised by uncontrollable hair twisting and pulling, often resulting in bald spots on an otherwise normal-haired person.

Impulse-control problems are at the heart of substance abuse disorders that is addiction to alcohol or drugs and many of the paraphilia, perversion sexual disorders such as exhibitionism, frotterism, and child molestation.

Below I will describe three of the most common that make headlines in our social media platforms:

1) Intermittent Explosive Disorder

It is characterised by uncontrolled fits of extreme anger and violence.

These multiple discrete episodes of failure to resist aggressive impulses result in serious assaultive acts or destruction of property.

The degree of aggressiveness expressed during the episodes is grossly out of proportion to any precipitating psychosocial stressors.

The aggressive episodes are not better accounted for by another mental disorder (e.g. Antisocial Personality Disorder, Borderline Personality Disorder, and a Psychotic Disorder.

2) Kleptomania Symptoms

Is characterised by recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.

This is an irresistible urge to steal various items from stores and homes.

There is increasing sense of tension immediately before committing the theft and pleasure, gratification, or relief at the time of committing the theft.

This stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination.

3) Pyromania Symptoms

Deliberate and purposeful fire characterised by irresistible urges to set fires on more than one occasion.

There is tension or affective arousal before the act.

It is associated with fascination with, interest in, curiosity about, or attraction to fire and its situational contexts consequences.

The individual loves to witness or participate in the aftermath.

The fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances, but in response to a delusion or hallucination, or as a result of impaired judgment.

I have seen several social media cases of this; they are psychiatric cases in need of help and medical care. Please refer them for appropriate psychiatric care. Dr Sacrifice Chirisa is a passionate mental health specialist at Parirenyatwa Hospital, one of the country’s major referral centres