Intermittent explosive disorder, first introduced in DSM-III, has now received more intensive research and clinical characterization, according to Coccaro (p. 577). The disorder consists of either high-intensity outbursts of aggression occurring several times yearly or less intensive outbursts several times monthly, a more treatable form. The disorder begins in adolescence or early adulthood; prevalence is about 5%. It appears to be separate from childhood disruptive behavioral disorders, such as conduct disorder and oppositional defiant disorder. Fluoxetine and cognitive-behavioral therapy together appear to have synergistic treatment effects.