From the Guidelines
Anger disorder, also known as intermittent explosive disorder (IED), should be treated with a combination of psychotherapy and medication, prioritizing cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) as the first line of treatment. According to the study 1, IED is characterized by repeated brief episodes of verbal or physical aggression or destruction of property representing a failure to control aggressive impulses. Key aspects of treatment include:
- Psychotherapy: CBT is the most effective approach, helping patients identify anger triggers and develop coping strategies.
- Medication: SSRIs like fluoxetine or sertraline are commonly prescribed, with mood stabilizers such as valproate or carbamazepine used for more severe cases.
- Lifestyle modifications: Regular exercise, stress management techniques, and avoiding alcohol and drugs can significantly reduce anger episodes. These interventions address both the neurochemical imbalances and the learned behavioral patterns that contribute to anger outbursts, as noted in the changes from ICD-10 to ICD-11 1. Early intervention is crucial as untreated anger disorders can lead to significant personal, social, and occupational problems. It is essential to monitor treatment response and adjust the therapeutic plan as needed to ensure optimal outcomes and minimize the risk of morbidity and mortality associated with untreated anger disorders.
From the Research
Definition and Prevalence of Anger Disorder
- Anger is a common and debilitating psychological problem among various psychiatric populations 2
- It is a key criterion in five diagnoses within DSM-5: Intermittent Explosive Disorder, Oppositional Defiant Disorder, Disruptive Mood Dysregulation Disorder, Borderline Personality Disorder, and Bipolar Disorder 3
Treatment of Anger Disorder
- Cognitive behavioral treatments are the most commonly disseminated intervention for both anger and aggression 2
- Anger treatments have consistently demonstrated at least moderate effectiveness among both non-clinical and psychiatric populations 2
- Combining selective serotonin reuptake inhibitors (SSRIs) with cognitive behavioral therapy (CBT) may be effective in treating depression and anxiety, which can be related to anger disorder 4
Related Disorders and Treatments
- SSRIs have been proven to be effective in treating panic disorder and agoraphobia, which can be associated with anger disorder 5
- SSRIs are also effective in treating other disorders such as major depression, dysthymia, obsessive-compulsive disorder, eating disorders, and premenstrual dysphoric disorder 6
- The combination of an antidepressant with exposure therapy may produce the greatest treatment gains in panic disorder and agoraphobia 5