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K-L

Kleptomania

Kleptomania was first described in 1838 and is classified as one of the impulse control disorders. The patient with kleptomania has an irresistible urge to steal objects, but isn’t motivated by monetary gain, anger, or revenge. Many times he doesn’t need the items and also has the ability to pay for them. Sometimes the patient keeps and hides the objects or may simply give them away. These behaviors are highly ritualistic. Indeed, the patient with kleptomania shares similar characteristics with the patient who has obsessive-compulsive disorder.

Stealing initially brings the patient gratification but is quickly followed by feelings of guilt, shame, and remorse. The theft is solitary and is usually unplanned, and the patient won’t usually steal when it’s obvious that he would be arrested.

CAUSES AND INCIDENCE

It’s estimated that the prevalence of kleptomania is about 0.6% in the general population. However, the true incidence of kleptomania is probably underreported because patients are often ashamed to seek help and often only receive help after they have been referred by the criminal justice system following their arrest. Of those arrested for shoplifting, the incidence is about 5%.

Kleptomania affects three times as many females as males. It may begin in childhood but is more typical in adolescence and adulthood. The exact cause of kleptomania isn’t known. Sometimes patients develop it after suffering brain trauma. Research into the neurobiology of the brain has shown that there may be dysfunction in the regulation of dopamine and of circuits that modulate human motivation. Research also continues into identifying dysfunction in the regulation of levels of serotonin. In some patients, episodes of kleptomania are linked to substance abuse, which may increase impulsivity and diminish inhibition. Some studies have demonstrated that patients with kleptomania have a higher-thannormal incidence of having a close relative with obsessive-compulsive disorder. Kleptomania is also associated with having mood, eating, and personality disorders.

SIGNS AND SYMPTOMS

The patient with kleptomania may report:

• powerful urges to steal

• feelings of tension before stealing

• pleasure while stealing

• remorse after stealing

• stealing items that have no value to the individual

• stealing only one type of item (fetishism)

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