Kleptomania

Kleptomania

Our text describes a number of disorders with an irresistible impulse-usually one that will ultimately be harmful to the person affected. However, DSM-IV-TR includes fives additional impulse-control disorders (Called impulse -control disorders not elsewhere classified) that are not included under other categories...intermittent explosive disorder, pyromania, pathological gambling, trichotillomania, and kleptomania.

Kleptomania (impulsive stealing)

Origin

Kleptomania is a strong desire to steal. Often a kleptomaniac person steals things he could have bought easily or things that are not at all expensive. The person steals just for the tension or the kick. Kleptomania can be the result of emotional shortcomings during the youth.

The DSM IV says about Kleptomania:

DSM-IV 312.32 KleptomaniaDiagnostic Features

The DSM-IV states that the essential feature of Kleptomania is the recurrent failure to resist impulses to steal items even though the items are not needed for personal use or for their monetary value

1. (Criterion A). The individual experiences a rising subjective sense of tension before the theft

2. (Criterion b) and feels pleasure, gratification, or relief when committing the theft

3. (Criterion C).The stealing is not committed to express anger or vengeance, is not done in response to a delusion or hallucination

4. (Criterion D), and is not better accounted for by Conduct Disorder, a Manic Episode, or Antisocial Personality Disorder

5. (Criterion E). The objects are stolen despite the fact that they are typically of little value to the individual, who could have afforded to pay for them and often gives them away or discards them.

Occasionally the individual may hoard the stolen objects or surreptitiously return them. Although individuals with this disorder will generally avoid stealing when immediate arrest is probable (e.g., in full view of a police officer), they usually do not preplan the thefts or fully take into account the chances of apprehension. The stealing is done without assistance from, or collaboration with, others.

Symptoms

Kleptomanics have an irresistible inclination to steal. Often they throw away the stolen goods. They are mostly interested in the kick of the stealing itself. Although psychiatrists consider kleptomania as a disease, this is not a legal excuse in front of an American or British court.

DSM-IV 312.32 Kleptomania Associated Features and Disorders

Individuals with Kleptomania experience the impulse to steal as ego-dystonic and are aware that the act is wrong and senseless. To be diagnosed, a person must have the typical pattern: recurrent tension leading to the behavior, leading to relief or pleasure after performing the behavior. The stealing is not accounted for by an external motive like hunger or financial deprivation or vengeance, or accounted for better by another disorder of which stealing is a part (for example, Antisocial Personality Disorder or a manic episode). Mood Disorders (especially Major Depressive Disorder), Anxiety Disorder, Eating Disorders (Particularly Bulimia Nervosa), and Personality Disorders may be associated with Kleptomania, The disorder may cause legal, family, career, and personal difficulties as evident by one Ms. Winona Ryder.

Prevalence

Kleptomania is a rare condition that appears to occur in fewer than 5% of identified shoplifters. It appears to be much more common in females.

Treatment

Only case study reports of treatment exist, and these involve either behavioral intervention or the use of antidepressant medication. It is thought important to find another occupation to replace the stealing activity. It is also very important to make the patient realize that others are harmed by the stealing activities. Treatment is largely untested, and the disorder often persists despite many convictions of shoplifting. It may decrease as the individual ages, however.

Course

There is little systematic information on the course of Kleptomania, but three typical courses have been described: sporadic with brief episodes and long periods of remission; episodic with protracted periods of stealing and periods of remission; and chronic with some degree of fluctuation. The disorder may continue for years, despite multiple convictions for shoplifting.

Differential Diagnosis

Kleptomania should be distinguished from ordinary acts of theft or shoplifting. Ordinary theft (whether planned or impulsive) is deliberate and is motivated by the usefulness of the object or its monetary worth. Some individuals, especially adolescents, may also steal on a dare, as an act of rebellion, or as a rite of passage. The diagnosis is not made unless other characteristic features of Kleptomania are also present. Kleptomania is exceedingly rare, whereas shoplifting is relatively common. In malingering, individuals may simulate the symptoms of Kleptomania to avoid criminal prosecution. Antisocial Personality Disorder and Conduct Disorder are distinguished from Kleptomania by a general pattern of antisocial behavior.

Kleptomania should be distinguished from intentional or inadvertent stealing that may occur during a Manic Episode, in response to delusions or hallucinations (e.g., in Schizophrenia), or as a result of dementia.

Comparison Between Kleptomania

and Addictive-Compulsive Stealing

KLEPTOMANIA ADDICTIVE-COMPULSIVE THEFT

* Recurrent failure to resist impulses to steal objects not needed for personal use or their monetary value (no premeditation) * Recurrent failure to resist obsessive, addictive, or compulsive thoughts/urges to steal objects which often are used even if not needed (degrees of premeditation).

* Increasing sense of tension immediately before committing the theft. * Already ever-present tension usually well before commission of the theft.

* Pleasure or relief at the time of committing the theft (often not fully aware of committing the theft and usually no guilt after) * Pleasure/relief at time of or just after committing theft (more conscious of act than kleptomaniac and usually feels guilt or shame after)

* The stealing is not committed to