Rounds in the General Hospital Prim Care Companion CNS Disord February 2026

Impulsivity: Differential Diagnosis, Evaluation, and Management

PCC CNS Disord 2026;28(1):10.4088/PCC.25f04058

Full Article Read the complete peer-reviewed article in Prim Care Companion CNS Disord. Clinical Summary Impulsive behavior can damage relationships, finances, work, and safety, but it is not a diagnosis by itself. In older adults, new-onset spending, gambling, sexual or social disinhibition, and other out-of-character behaviors may signal mild cognitive impairment, frontal-executive dysfunction, or an emerging neurodegenerative disorder rather than a primary psychiatric syndrome alone. FAQ What is the difference between impulsivity and compulsivity?

Key Takeaways Differentiate impulsivity from compulsivity at the bedside: impulsive acts are rapid and poorly planned responses to internal or external triggers, whereas compulsive behaviors are repetitive and ritualistic attempts to reduce distress or prevent a feared outcome. Clinical Guide How should clinicians evaluate new-onset impulsive behavior in an older adult? Clinical Guide How can clinicians manage impulsivity in an older adult with frontal-executive features and reward-seeking behaviors?