Kleptomania

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Kleptomania
ICD-10 F63.2
ICD-9 312.32

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Overview

Kleptomania (Greek language|Greek: κλέπτειν, kleptein, "to steal", μανία, "mania") is an inability or great difficulty in resisting impulses of stealing. People with this disorder are compelled to steal things, generally things of little or no value, such as pens, paper clips, small toys, or packets of sugar. Some may not be aware that they have committed the theft until later. The majority of kleptomaniacs sometimes have preferences to certain items (again, usually subconsciously); for example, battery (electricity)|batteries or television remote controls.[citation needed] Although a kleptomaniac may steal uncontrollably without realization, judiciary|judicial courts in the United Kingdom and United States generally do not accept kleptomania as an affirmative defense. 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]

Differential Diagnosis

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 compulsed.

Epidemiology and Demographics

Prevalence

The prevalence of kleptomania is:

  • 4,000-24,000 per 100,000 (4%-24%) in individuals arrested for shoplifting
  • 300-600 per 100,000 (0.3%-0.6%) in the overall population[5]

Diagnostic Criteria

DSM-V Diagnostic Criteria for Kleptomania[5]

  • A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.

AND

  • B. Increasing sense of tension immediately before committing the theft.

AND

  • C. Pleasure, gratification, or relief at the time of committing the theft.

AND

  • D. The stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination.

AND

E. The stealing is not better explained by conduct disorder, a manic episode, or antisocial personality disorder.

Treatment

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.[6] The only open-trial of medication for kleptomania showed naltrexone significantly reduced the intensity of urges to steal, stealing thoughts and stealing behavior.[7] A similar three year follow-up of patients treated only with naltrexone showed a clinically significant reduction in kleptomanic behavior.[8]

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.[9].

Prevalence rates between the two disorders do not demonstrate a strong relationship. Studies examing the comorbidity of OCD in subjects with kleptomania have inconsistent results, with some showing a relatively high co-occurrence (45%-60%)[10][11] while others demonstrate low rates (0%-6.5%).[12][13] Similarly, when rates of kleptomania have been examined in subjects with OCD, a relatively low co-occurrence was found(2.2%-5.9%).[14] [7]

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]". Türk psikiyatri dergisi = Turkish journal of psychiatry (in Turkish). 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. 5.0 5.1 5.2 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  6. Dannon PN, Aizer A, Lowengrub K, (2006): Kleptomania: Differential Diagnosis and Treatment Modalities. Current Psychiatry Reviews. 2(2) 281-283.
  7. 7.0 7.1 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.
  8. Grant JE (2005). "Outcome study of kleptomania patients treated with naltrexone: a chart review". Clinical neuropharmacology. 28 (1): 11–4. PMID 15711433.
  9. Grant JE, Kim SW (2002). "Clinical characteristics and associated psychopathology of 22 patients with kleptomania". Comprehensive psychiatry. 43 (5): 378–84. PMID 12216013.
  10. 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. PMID 11788913.
  11. 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.
  12. 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. PMID 12900315. Full text available
  13. 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.
  14. Fontenelle LF, Mendlowicz MV, Versiani M, (2005) Impulse control disorders in patients with obsessive-compulsive disorder. Psychiatr Clin Neurosci. 59:30-37.



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