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Kleptomania

Kleptomania is one of five categories of Impulse Control Disorders. It is characterized by stealing items of limited value or use to the patient, from stores, acquaintances, or strangers. Like other impulse control disorders, Kleptomania involves an anxiety-provoking urge to perform an act that is satisfying at the moment but subsequently leads to guilt. Most shoplifters do not suffer from kleptomania, though Kleptomaniac patients may engage in illegal behavior. Kleptomania differs from shoplifting, in that shoplifting is typically planned, and the person stealing remains guilt-free and is motivated by need or monetary gain.

Those suffering from Kleptomania experience an increasing sense of anxiety and tension just before committing theft. This anxiety is relieved at the time of the theft, and sometimes the patient is not fully aware that they are stealing, until after the theft. The theft is not committed to exact revenge or express anger, and it is not due to other mental disorders like Conduct Disorder or Antisocial Personality Disorder. Patients can generally afford to purchase the item, and once it is stolen, they may often give it away, because it is not the need for the item that drives the impulse. Some doctors believe that kleptomania is a symptom of the obsessive-compulsive spectrum of disorders, because many patients experience the impulse to steal as an unwanted and intrusive thought, and one that they cannot control. Other research seems to suggest that kleptomania may be related to, or an offshoot of a mood disorder, or depression.

Kleptomania may appear during childhood or adolescence, but it is often diagnosed later. The average kleptomania patient is about 35 years old, female and has suffered from the disorder for approximately 16 years. The cause of this impulse control disorder is not known, but some research indicates that it is linked to an imbalance in brain chemicals, specifically serotonin. Stressful events like a death in the family or a divorce may precipitate kleptomanic behavior.

What are the symptoms?

• Inability to control the impulse to steal
• Increased anxiety and tension before committing theft
• Theft is not for revenge or to express anger and patient is not delusional or experiencing hallucinations
• Theft of items that are not needed or wanted
• Relief of anxiety after theft

How is it diagnosed and treated?

Because some other disorders can have similar symptoms, the doctor will perform a full medical and mental examination to rule out other disease or illness. Specifically, doctors will rule out an ordinary act of theft or shoplifting, bipolar disorder, conduct disorder, antisocial personality disorder, and manic episodes resulting from delusions.

After ruling out other medical conditions or mental disorders, the diagnosis is then based on the symptoms detailed above.

Treatment(s) can include:

• Psychotherapy
• Medications like naltrexone, fluovoxamine, paroxtine, fluoxetine, antidepressants, as appropriate
• Family Therapy

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