Impulse Control Disorders Kleptomania

The prominent feature of impulse control disorders is the repeated inability to stop behaving impulsively, or to resist the desire for short term satisfaction from behaviors and actions that result in great long term loss or harm.

Like other psychological disorders there is a profound inability to retain or to gain control in various situations. There is some form of pleasure or tension relief from the behavior, even when the behavior is disfiguring or painful. There is tension before the act of compulsion and there is either pleasure or relief afterward.

Kleptomania is the act of taking items that are not needed for personal or monetary value. This does not relate to criminal behavior where career thieves steal in order to make monetary or personal gain.  Panic attacks, bulemia, social phobia can accompany this disorder. In depression, the stealing provides a thrill that eases the symptoms. Bulimia nervosa, obsessive compulsive disorder and depression are most often related to kleptomania.

Kleptomania is one of the rarer impulse control disorders, at .6 percent of the population, with women as the predominant group. The causes are unknown, but there are some beliefs that this is a genetic element that is shared between first degree relatives. 

Stealing from desperation, to support substance abuse habits, or during manic episodes are not generally related to the diagnosis of true kleptomania.

The acts of stealing result in tension release and gratification, but term “ego dystopia” applies, as the sufferer feels guilt and does not want to steal, but is compelled to steal, anyway. As such kleptomania has factors in common with obsessive-compulsive disorder. There is also a lack of desire for revenge or to express anger.

Diagnosis of kleptomania tends to be more likely when patients seek treatment for other disorders, since kleptomaniacs do not tend to self report.  In some cases, dysfunctional parenting, major stresses and traumas, or even an inexplicable focus on or preference for a specific item or specific settings for stealing might be involved. The patient may not even be able to state why there is such a preference or focus.

Treatment aims at controlling impulses and preventing relapses. The associated disorders must also be treated. Cognitive-behavioral  therapy, rational emotive therapy, fluoxetine and naltrexone are the theraputic drugs that may apply.

This is such a little known disorder that prognosis for therapy or even ways to prevent development of the disorder are limited.