Which diagnosis should not be included in the differential for intermittent explosive disorder?

Intermittent explosive disorder (IED) is characterized by recurrent episodes of aggressive behavior, typically resulting in a verbal or physical outburst that is disproportionate to the situation. In constructing a differential diagnosis for IED, it's essential to consider other conditions that may result in explosive or aggressive behavior.

Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessions (intrusive and unwanted thoughts) and compulsions (repetitive behaviors performed to alleviate anxiety caused by these obsessions). While individuals with OCD may exhibit irritability and frustration due to their symptoms, this does not typically manifest as the explosive outbursts seen in IED. Instead, aggression is not a core feature of OCD, and while there may be some overlap in terms of anxiety and stress-induced irritability, the nature of the aggression in OCD is more controlled and less impulsive, standing in contrast to the impulsivity central to IED.

In contrast, conditions like delirium, dementia, and substance intoxication can lead to aggressive behaviors or outbursts, making them relevant to the differential for IED. Delirium often presents with confusion and fluctuating levels of consciousness, which can contribute to irritability or aggression. Dementia may also lead