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Pyromania

Pyromania is one of several Impulse Control Disorders. Pyromania is characterized by an impulse to set fires, and involves deliberate and purposeful fire setting with tension or heightened arousal prior to the act and gratification or relief following the act of setting the fire. The fire is not set for monetary gain out of any sense of revenge or anger. It is normal for some children to go through a stage where they are fascinated by fire. However, once they are taught about that fire is dangerous, this fascination is typically tempered by safety concerns. Some children will still play with fire, infrequently, and this is a frightening prospect for parents, but it does not qualify as a psychiatric disorder.

Pyromania involves planning and is more compulsive than impulsive. Pyromania is not diagnosed unless a patient has deliberately set more than one destructive fire, with no external motive like collecting insurance money or covering up a crime. It is not diagnosed where fire setting is part of another illness like Conduct Disorder in children, or psychotic processes that occur in Schizophrenia or Bipolar Disorder, or if the person sets the fire in response to a delusion or hallucination. Adolescent fire setting is usually associated with Conduct Disorder, ADHD, or Adjustment Disorder. Pyromania occurs more commonly in males, especially those with poor social skills and learning difficulties. Pyromaniacs often have poor learning skills, learning disabilities, or problems dealing with other people or social situations. Most childhood cases of Pyromania do resolve, but untreated adult cases do not.

What are the symptoms?

• Deliberate, purposeful fire setting on more than one occasion
• A fascination with and attraction to fire, fire alarms, fire paraphernalia
• Fire is not set for money, anger, social or political reasons, or to conceal criminal activity
• Tension or anxiety prior to the action, followed by relief after the fire is set
• Patient likes to watch fires of any kind
• Fire setting is not better accounted for by delusion, hallucination, dementia, retardation, substance abuse or other mental disorder like Conduct Disorder, Bipolar Disorder, Schizophrenia

How is it diagnosed and treated?

Doctors will rule out other disorders and disease prior to diagnosing Pyromania. Some disorders (Antisocial Personality Disorder, Conduct Disorder, Manic Episodes in Bipolar Disorder, Substance Abuse, Mental Retardation, and Psychosis) can exhibit similar signs.

Doctors will perform a thorough physical and mental health evaluation to rule out other disease, and will look for the following signs:

• Patient does not have any other motive or illness that might explain the fire setting
• Patient experiences relief from tension after setting fire
• Patient has set more than one purposeful fire

Treatment(s) can include:

• Cognitive Behavioral Therapy
• Self-Help Groups
• Psychotherapy
• Medication as appropriate to prevent aggressive outbursts and anxiety

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