Kleptomania involves
a failure to resist impulses to steal items that are not needed or
sought for personal use or monetary value. Kleptomania should be distinguished
from shoplifting, in which the action is usually well-planned and
motivated by need or monetary gain. Some clinicians view kleptomania
as part of the obsessive-compulsive
spectrum of disorders, reasoning that many individuals experience
the impulse to steal as an alien, unwanted intrusion into their mental
state. Other evidence suggests that kleptomania may be related to,
or a variant of, mood disorders, such as depression.
The main diagnostic features are:
The person repeatedly yields to the impulse to steal objects that
are needed neither for personal use nor for their monetary worth.
Just before the theft, the patient experiences increasing tension.
At the time of theft, the patient feels gratification, pleasure or
relief.
These thefts are committed neither out of anger or revenge nor in
response to delusions or hallucinations.
The thefts are not better explained by Antisocial
Personality Disorder, Conduct
Disorder or a Manic
Episode.
Associated
Features:
Depressed
or Guilty (concerning the thefts)
Major Depressive Disorder
Anxiety.
Differential
Diagnosis:
Some disorders have similar or even the same symptoms. The clinician,
therefore, in his/her diagnostic attempt, has to differentiate against
the following disorders which need to be ruled out to establish a
precise diagnosis.
An Ordinary
Criminal Act.
Bipolar Mood Disorder.
Conduct Disorder.
Antisocial
Personality Disorder.
Manic Episode
in response to Delusions or
Dementia.
Cause:
Most person's
with this disorder seem to be women; their average age is about 35
and the duration of illness is roughly 16 years. Some individuals
report the onset of kleptomania as early as age five. While we do
not know the causes of kleptomania, there is indirect evidence linking
it with abnormalities in the brain chemical serotonin. Stressors such
as major losses may also precipitate kleptomanic behavior.
Treatment:
A variety of psychotherapies have been used to treat this disorder,
but it is not clear which one is best. Family
therapy may also be important, since this disorder can be very disruptive
to families.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Prozac, an antidepressant
that boosts levels of serotonin, has been found useful in some cases
of kleptomania.
