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When People Aren’t Responsible for Violent Acts – Episodic Dyscontrol Disorder

Like Tourette’s, there are some disorders which may present with behaviour that is condemned by society. The population must be enlightened about these disorders before hasty judgements are made.

Forensic psychiatrists may deal with people who perpetrate violent acts but cannot be held to account for these violent acts. For instance they may suffer from psychosis, which is detachment from reality, as part of a mental illness such as schizophrenia. Other less heard of conditions may also cause violent acts. Examples include intermittent explosive disorder and the topic of this article episodic dyscontrol disorder.

This syndrome is typified by sudden outbursts of violence, which are usually unprovoked and out-of character. Outbursts may vary from a few seconds to a few hours. They may be preceded by a pro-dromal aura such as a sensation of numbness, audio-visual disturbances, headaches and lethargy. Thus the disorder is similar to temporal lobe epilepsy. Following the violent outburst, a period of amnesia for the episode may occur.

The disorder is rare in general, but tends to be more prevalent in children. It affects males more than females.

In children, these violent outbursts may manifest as destruction of toys, or physical attacks on other children. Normally these outbursts are unprovoked and the patient may have feelings of guilt after these outbursts. In cases where there is provocation, the ensuing aggressive outburst may be disproportional to

The features of the disorder make it hard to distinguish from epilepsy; it remains unclear whether episodic dyscontrol disorder is a disorder in its own right. An EEG (electroencephalogram) of patients with episodic dyscontrol may show abnormalities such as non-specific slow wave activity.

(Source: http://ese.wustl.edu/~nehorai/eegmeg/eeg2.jpg)

Some physical abnormalities in the emotional and affective network of the brain, the limbic system, are thought to underlie the syndrome. Management of the disorder can be pursued medically. Drugs such as carbamazepine and phenytoin have been shown to be useful the treatment of the disorder.

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