What is Kleptomania?
Kleptomania, is the repetitive, uncontrollable stealing of items not needed for personal use. It is a disabling disorder that often goes unrecognized among mental health professionals and law enforcement.
Although kleptomania is recognized as a true psychiatric disorder, with a prevalence of about 0.7% in the general population, it remains a poorly understood. Currently classified in impulse-control disorders, kleptomania is defined by three essential features:
- failure to resist an impulse to steal unneeded objects;
- an increasing sense of tension or arousal before committing the theft; and
- an experience of pleasure, gratification, or release at the time of committing the theft.
The stealing behavior associated with kleptomania leads to personal distress, legal problems, and social and marital dysfunction.
Kleptomaniacs often steal objects that are of little value, that the person could have easily managed to buy. The person with kleptomania may hoard the stolen object, give it away, or discard it.
The stealing is not done to consciously express anger, or in response to a delusion or hallucination. It is not attributed to juvenile delinquency (i.e. conduct disorder), a mood disorder (i.e. bipolar disorder), or sociopathic tendencies (i.e. antisocial personality disorder).
Many patients with kleptomania report an altered state of consciousness during acts of theft called depersonalization — whereby they may feel detached from their bodies or in a dream-like state.
Those who suffer from kleptomania experience shame and guilt, unlike ordinary shoplifters, which may lead the person to secretly return stolen items. Although someone with this disorder will generally avoid stealing when immediate arrest is probable (such as in full view of a security guard or police officer), they usually do not plan the thefts or fully take into account the chances of being caught. The stealing is done independently, without collaboration with others.
What Causes Kleptomania?
Because most shoplifters appeared to be women, the discussion of kleptomania in the 19th and early 20th centuries became part of the ongoing medical debate about the relationship of insanity to the female reproductive system. "Hysteria" was thought to be caused by the uterus, thus kleptomania was discussed alongside other diseases of female reproductive organs.
Although shoplifting has continued unabated since the 19th century, the labeling of certain shoplifters as kleptomaniacs largely disappeared by 1920. This may have occurred for several reasons, including the fact that no one in the scientific community was able to prove that female reproductive issues caused shoplifting, and greater numbers of men were being arrested for shoplifting.
More recently, kleptomania has been conceptualized as an obsessive compulsive spectrum disorder, but emerging evidence suggests that kleptomania may have important similarities to both addictive and mood disorders, which may help researchers better understand how to treat kleptomania.
The people with kleptomania are not necessarily more likely than others to have major depression, obsessive-compulsive disorder, or bipolar disorder (manic depression), but they are more likely to have another
impulse-control disorder or substance abuse problem. There seems to be some genetic component to the illness, as kleptomaniacs are more likely to have close relatives who suffer from a substance use disorder as well.
Treatment of Kleptomania
Traditionally, the treatment of choice for kleptomania was insight-oriented therapy, aimed at dealing with underlying psychological problems that may be contributing to the urge to steal. However, most recent research has focused on the benefits of cognitive-behavior therapy, which has shown some effectiveness in the treatment of kleptomania.
There are also several medications that have been issued to treat kleptomania, including fluvoxamine, paroxetine, lithium, valproate, buspirone, and naltrexone.
There is some evidence that selective serotonin reuptake inhibitors (SSRIs), the treatment of choice for anxiety disorders and depression, are not as effective for kleptomania. Instead, other medications (such as opioid antagonists and mood stabilizers) have shown early promise in treating kleptomania. More research is needed to determine how best to treat this puzzling disorder.
- Family history and psychiatric comorbidity in persons with kleptomania. Grant, Jon E.; Comprehensive Psychiatry, Vol 44(6), Nov-Dec 2003. pp. 437-441.
- Kleptomania. Grant, Jon; Kim, Daniel; In: Mental disorders of the new millennium: Behavioral issues (Vol. 1). Plante, Thomas G.; Westport, CT, US: Praeger Publishers/Greenwood Publishing Group, 2006. pp. 99-115.