Kleptomania
Definition
Kleptomania is an impulse control disorder characterized by a recurrent failure to resist stealing.
Description
Kleptomania is a complex disorder characterized by repeated, failed attempts to stop stealing. It is often seen in patients who are chemically dependent or who have a coexisting mood, anxiety, or eating disorder. Other coexisting mental disorders may include major depression, panic attacks, social phobia , anorexia nervosa , bulimia nervosa , substance abuse, and obsessive-compulsive disorder . People with this disorder have an overwhelming urge to steal and get a thrill from doing so. The recurrent act of stealing may be restricted to specific objects and settings, but the affected person may or may not describe these special preferences. People with this disorder usually exhibit guilt after the theft.
Detection of kleptomania, even by significant others, is difficult and the disorder often proceeds undetected. There may be preferred objects and environments where theft occurs. One theory proposes that the thrill of stealing helps to alleviate symptoms in persons who are clinically depressed.
Causes and symptoms
Causes
The cause of kleptomania is unknown, although it may have a genetic component and may be transmitted among first-degree relatives. There also seems to be a strong propensity for kleptomania to coexist with obsessive-compulsive disorder, bulimia nervosa, and clinical depression.
Symptoms
The handbook used by mental health professionals to diagnose mental disorders is the Diagnostic and Statistical Manual of Mental Disorders . Published by the American Psychiatric Association, the DSM contains diagnostic criteria and research findings for mental disorders. It is the primary reference for mental health professionals in the United States. The 2000 edition of this manual (fourth edition, text revision), known as the DSM-IV-TR, lists five diagnostic criteria for kleptomania:
- • Repeated theft of objects that are unnecessary for either personal use or monetary value.
- • Increasing tension immediately before the theft.
- • Pleasure or relief upon committing the theft.
- • The theft is not motivated by anger or vengeance, and is not caused by a delusion or hallucination.
- • The behavior is not better accounted for by a conduct disorder , manic episode , or antisocial personality disorder.
Demographics
Studies suggest that 0.6% of the general population may have this disorder and that it is more common in females. In patients who have histories of obsessive-compulsive disorder, some studies suggest a 7% correlation with kleptomania. Other studies have reported a particularly high (65%) correlation of kleptomania in patients with bulimia.
Diagnosis
Diagnosing kleptomania is usually difficult since patients do not seek medical help for this complaint, and initial psychological assessments may not detect it. The disorder is often diagnosed when patients seek help for another reason, such as depression, bulimia, or for feeling emotionally unstable (labile) or unhappy in general (dysphoric). Initial psychological evaluations may detect a history of poor parenting, relationship conflicts, or acute stressors—abrupt occurrences that cause stress, such as moving from one home to another. The recurrent act of stealing may be restricted to specific objects and settings, but the patient may or may not describe these special preferences.
Treatments
Once the disorder is suspected and verified by an extensive psychological interview, therapy is normally directed towards impulse control, as well as any accompanying mental disorder(s). Relapse prevention strategies, with a clear understanding of specific triggers, should be stressed. Treatment may include psychotherapies such as cognitive-behavioral therapy and rational emotive therapy . Recent studies have indicated that fluoxetine (Prozac) and naltrexone (Revia) may also be helpful.
Prognosis
Not much solid information is known about this disorder. Since it is not usually the presenting problem or chief complaint, it is frequently not even diagnosed. There are some case reports that document treatment success with antidepressant medications, although as with almost all psychological disorders, the outcomes vary.
Prevention
There is little evidence concerning prevention. A healthy upbringing, positive intimate relationships, and management of acutely stressful situations may lower the incidence of kleptomania and coexisting disorders.
Resources
BOOKS
Tasman, Allan, Jerald Kay, and Jeffrey A. Lieberman, eds. Psychiatry. 1st ed. Philadelphia: W. B. Saunders Company, 1997.
Laith Farid Gulli, M.D.
Kleptomania is a rare disorder that prevents those afflicted from resisting the urge to steal. People with the disorder are often called kleptos. Kleptos do not generally steal things of value. No cars, or jewelry, just small things like pens, paperclips, and small toys. Typical of psychological disorders, kleptos will find a pattern in their thieveries, and develop a preference for a certain item. Also typical of psychological disorders, those afflicted will often not realize they have committed the crime, until they empty their pockets, that is. The court system denounces kleptomania and tries most cases like shoplifting, despite the fact that regular thievery is for profit while kleptos generally steal things like spoons or pairs of panties, not exactly something you’d sell on eBay. Another difference is that most thieves premeditate their endeavors, while Kleptos act on impulse or subconsciously. Another thing that makes this a unique disorder is its co morbidity, which means it is likely to be coupled with other disorders, and oftentimes substance abuse. Causes of the disorder arise some speculation, with things like carbon monoxide exposure being blamed. Brain trauma also gets blame put upon it by kleptos. It is also assumed that the brain chemical serotonin is involved.
With that little bit of background knowledge, I will tell you how to diagnose kleptomania, describe some treatment, and tell you of its relations with obsessive-compulsive disorder. The Diagnostic and Statistical Manual of Mental Disorders, as used by a majority of professionals, now in its 4th edition, has a five point criterium for diagnosing kleptomania. They must be careful, because diagnosing a common theif with kleptomania is like handing him a get out of jail free card in some situations. Kleptos have definite urges to steal items with little monetary value that they have no psychological control over. A sense of tension before the grab is also experienced. After a theivery, feelings of pleasure, gratification or even pride are felt. The steal is not for anger or revenge, and is not brought on by a delusion or hallucination. Finally, the act cannot be better explained by another problem, specifically conduct disorder, manic episodes, or antisocial personality disorder. If a person meets this strict guideline, they may be treated in a variety of ways. For one, no matter what medication is provided, cognitive behavior therapy is often used in concordance. Basically the kleptos will keep a journal, be put through tests and activities, examined psychologically, and otherwise brainwashed out of their disorder. Meds include those used to combat addictive behaviors, and are found to be pretty effective. Opiod antagonists are what is used primarily. Meds to increase the seratonin levels also effect kleptomania in a positive way, meaning that antidepressants will cure theivery problems. Who knew? As I was saying earlier, kleptomania is slightly related to the ritualistic disorder called O.C.D. They both consist of involuntary actions that the victim does not necessarily welcome. There are also hoarding behaviors excercised by both population groups. Comorbidity rates do not supportor disprove this theory although the numbers do not point in support for those that think the conditions are related.
Kleptomania is as much a mystery as Atlantis, but with the knowledge we have we have been able to quell the urges but there is sadly no “cureâ€Â. As they say knowledge is power, so as we learn more about the condition itself, the closer we will get to ending it. As of right now, there is only so much we can do with psychotherapy.
Just kind of wanted some answers, and someone to talk to.
JESS.
i know she has been using nerve pills to try to feel better which is not helping. i dont know how to help her.
However, my son did not steal until he started taking Vyvance. Prior to the Vyvance he was on Intuniv which I truly believe is what triggered the picking to begin but now has become worse since the Vyvance.
In the beginning I was pleased with the Intuniv because my son's handwriting became very legible. However, I noticed lots of sores on his skin that he had picked. (he's not aware of the picking)
What can I do or say as a parent to have the doctors to look in to this more in depth?
1. You do not need the things you take- you do NOT steal because you are tight, you a have a biological problem (although this is only 1 theory and widely debated)
2. There is an irresistible urge past general control- you have random outbursts that are physically impossible to avoid, and ONLY through cognitive behavioral therapy, medication, aversion therapy, combination therapy, etc. can you sometimes over come this urge.
3. It usually is just a symptom of another problem- for example, there is a large correlation between depression and people with KM
Please stop self-diagnosing. It's inaccurate and can actually cause more harm to your mental state. Thank you.