Editorial: Moving From Concept to Proof in the Distinction Between Phasic and Tonic Irritability

Abstract

In child and adolescent psychiatry, irritability is listed as a cardinal or associated symptom in nearly every emotional, behavioral, and neurodevelopmental disorder in the DSM-5. Despite the omnipresence of irritability in distinct psychiatric disorders, its manifestation is highly heterogeneous, across and within individuals. Part of that heterogeneity has to do with its temporal dynamics. Specifically, irritability has been conceptualized as having 2 components, termed phasic and tonic irritability.¹ Phasic irritability has been defined as relatively short-lived temper outbursts of intense anger that can be accompanied by verbal or physical aggression, whereas tonic irritability has been defined as persistently angry or grumpy mood. Despite this conceptual distinction, it is still unclear whether phasic and tonic irritability might differ in their clinical correlates, underlying mechanisms, longitudinal course, and/or treatment response.