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.
