Kleptomania

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Kleptomania
Classification and external resources
ICD-10 F63.2
ICD-9 312.32

Kleptomania (Greek: κλέπτειν, kleptein, "to steal", μανία, "mania") is an inability or great difficulty in resisting impulses of stealing. Frequently this term is used for riches that steal something.

People with this disorder are compelled to steal things, generally things of little or no value, such as pens, paper clips, tape, small toys, or packets of sugar. Some may not be aware that they have committed the theft.

Kleptomania was first officially recognized in the US as a mental disorder in the 1960's in the case of the state of California v. Douglas Jones.

Kleptomania is distinguished from shoplifting or ordinary theft, as shoplifters and thieves generally steal for monetary value, or associated gains and usually display intent or premeditation, while people with kleptomania are not necessarily contemplating the value of the items they steal or even the theft until they are compelled. Of all reported shoplifting, only 1% are actually kleptomaniacs.

This disorder usually begins during puberty and usually lasts until late adulthood. In some cases, the disorder may never stop and lasts throughout the person's life. People with this disorder are likely to have a comorbid condition, specifically paranoid, schizoid or borderline personality disorder.[1] Kleptomania can occur after traumatic brain injury and carbon monoxide poisoning.[2][3]

Kleptomania is usually thought of as part of the obsessive-compulsive disorder spectrum, although emerging evidence suggests that it may be more similar to addictive and mood disorders. In particular, this disorder is frequently co-morbid with substance use disorders, and it is common for individuals with kleptomania to have first-degree relatives who suffer from a substance use disorder.[4]

Contents

[edit] Diagnosis

The DSM-IV-TR lists the following five criteria for kleptomania:

  • Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.
  • Increasing sense of tension immediately before committing the theft.
  • Pleasure, gratification, or relief at the time of committing the theft.
  • The stealing is not committed to express anger or revenge and is not in response to a delusion or a hallucination.
  • The stealing is not better accounted for by conduct disorder, a manic episode, or antisocial personality disorder.

[edit] Treatments

Kleptomania has several different treatments. Cognitive-behavioral therapy is recommended as an adjuvant to medication.

Some medications that are used for people diagnosed with kleptomania are selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists.[5] The only open-trial of medication for kleptomania showed naltrexone significantly reduced the intensity of urges to steal, stealing thoughts and stealing behavior.[6] A similar three year follow-up of patients treated only with naltrexone showed a clinically significant reduction in kleptomanic behavior.[7] Doctors in the US have been treating diagnosed kleptomaniacs with mood-altering drugs such as Prozac and Seroxat, on the presumption that it could be triggered by changes in the levels of serotonin in the brain, which is what they think happens in depression. Psychological counselling, to get at the underlying causes of unhappiness, is more likely to effect a long-term cure. Discussing the disorders with others with the same condition was also noted to help..

[edit] Relationship to OCD

Kleptomania is often thought of being a part of obsessive-compulsive disorder, since the irresistible and uncontrollable actions are similar to the frequently excessive, unnecessary and unwanted rituals of OCD. Some individuals with kleptomania demonstrate hoarding symptoms that resemble those with OCD.[8]. Prevalence rates between the two disorders do not demonstrate a strong relationship. Studies examining the comorbidity of OCD in subjects with kleptomania have inconsistent results, with some showing a relatively high co-occurrence (45%-60%)[9][10] while others demonstrate low rates (0%-6.5%).[11][12] Similarly, when rates of kleptomania have been examined in subjects with OCD, a relatively low co-occurrence was found(2.2%-5.9%).[13] [6]

[edit] References

  1. ^ Grant JE (2004). "Co-occurrence of personality disorders in persons with kleptomania: a preliminary investigation". J. Am. Acad. Psychiatry Law 32 (4): 395-8. PMID 15704625. 
  2. ^ Aizer A, Lowengrub K, Dannon PN (2004). "Kleptomania after head trauma: two case reports and combination treatment strategies". Clinical neuropharmacology 27 (5): 211-5. PMID 15602100. 
  3. ^ Gürlek Yüksel E, Taşkin EO, Yilmaz Ovali G, Karaçam M, Esen Danaci A (2007). "[Case report: kleptomania and other psychiatric symptoms after carbon monoxide intoxication]" (in Turkish). Türk psikiyatri dergisi = Turkish journal of psychiatry 18 (1): 80-6. PMID 17364271.  Full text available.
  4. ^ Grant JE (2006). "Understanding and treating kleptomania: new models and new treatments". The Israel journal of psychiatry and related sciences 43 (2): 81-7. PMID 16910369.  Full text PDF
  5. ^ Dannon PN, Aizer A, Lowengrub K, (2006): Kleptomania: Differential Diagnosis and Treatment Modalities. Current Psychiatry Reviews. 2(2) 281-283.
  6. ^ a b Matsunaga H, Kiriike N, Matsui T, Oya K, Okino K, Stein DJ (2005). "Impulsive disorders in Japanese adult patients with obsessive-compulsive disorder". Comprehensive psychiatry 46 (1): 43-9. doi:10.1016/j.comppsych.2004.07.001. PMID 15714194. 
  7. ^ Grant JE (2005). "Outcome study of kleptomania patients treated with naltrexone: a chart review". Clinical neuropharmacology 28 (1): 11-4. doi:10.1097/01.wnf.0000150868.06512.0b. PMID 15711433. 
  8. ^ Grant JE, Kim SW (2002). "Clinical characteristics and associated psychopathology of 22 patients with kleptomania". Comprehensive psychiatry 43 (5): 378-84. doi:10.1053/comp.2002.34628. PMID 12216013. 
  9. ^ Presta S, Marazziti D, Dell'Osso L, Pfanner C, Pallanti S, Cassano GB (2002). "Kleptomania: clinical features and comorbidity in an Italian sample". Comprehensive psychiatry 43 (1): 7-12. doi:10.1053/comp.2002.29851. PMID 11788913. 
  10. ^ McElroy SL, Pope HG, Hudson JI, Keck PE, White KL (1991). "Kleptomania: a report of 20 cases". The American journal of psychiatry 148 (5): 652-7. PMID 2018170. 
  11. ^ Baylé FJ, Caci H, Millet B, Richa S, Olié JP (2003). "Psychopathology and comorbidity of psychiatric disorders in patients with kleptomania". The American journal of psychiatry 160 (8): 1509-13. doi:10.1176/appi.ajp.160.8.1509. PMID 12900315.  Full text available
  12. ^ Grant JE (2003). "Family history and psychiatric comorbidity in persons with kleptomania". Comprehensive psychiatry 44 (6): 437-41. doi:10.1016/S0010-440X(03)00150-0. PMID 14610719. 
  13. ^ Fontenelle LF, Mendlowicz MV, Versiani M, (2005) Impulse control disorders in patients with obsessive-compulsive disorder. Psychiatr Clin Neurosci. 59:30-37.