KleptoMania

Introduction:

Kleptomania is the inability to refrain from the urge to steak items for reasons other than personal use or financial gain. First described in 1816, kleptomania is presently classified in psychiatry as an impulse control disorder. Alternatively, some of the main characteristics of the disorder, which consist of recurring intrusion feelings, an inability to resist the urge of steal, and a release of pressure following the theft, suggest that kleptomania could be an obsessive – compulsive spectrum disorder.

The disorder is frequently under-diagnosed and is regularly associated with other psychiatric disorders, particularly anxiety and eating disorders, and alcohol and substance abuse. Patients with kleptomania are typically treated with therapies in other areas due to the comorbid grievances rather than issues directly related to kleptomania.

Over the last 100 years, a shift from psychotherapeutic to psychopharmacological interventions for kleptomania has occurred. Pharmacological treatments using selective serotonin reuptake inhibitors (SSRIs), mood stabilizers and opioid receptor, antagonists and other antidepressants along with cognitive behavioral therapy, have yielded positive results.

Signs and Symptoms:

Some of the fundamental components of kleptomania include recurring intrusion thoughts, impotence to resist the compulsion to engage in stealing, and the release of pressure following the act. These symptoms suggest that kleptomania could be regarded as an obsessive- compulsive type of disorder.

Persons diagnoses with kleptomania often have other types of disorders involving mood, anxiety, eating, impulse control, and drug use. They also have great levels of stress, guilt and remorse, and privacy issues accompanying the act of stealing. These signs are considered to either cause or intensify general comorbid disorders. The characteristics of the behaviors associated with stealing  could result in other problems as well, which include social segregation and substance abuse. The many types of other disorders frequently occurring along with kleptomania usually make clinical diagnosis uncertain.

Diagnosis

Disagreement surrounds the method by which kleptomania is considered and diagnosed. On one hand, some researchers believe that kleptomania is merely theft and dispute the suggestion that there are psychological mechanisms involved, while others observe kleptomania as part of a substance-related addiction. Yet others categorize kleptomania as a variation of an impulse control disorder, such as obsessive –complusive disorder or eating disorders.

According to the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSMIV-TR), a frequent and widely used guide for the diagnosis of mental disorders, the following symptoms and characteristics are the diagnostic criteria for kleptomania repeated inability to defend against urges to steal things that are not essential for private use or for their economic status escalating sense of pressure immediately prior to performing the theft; satisfaction, fulfillment or relief at the point of performing the theft; the theft is not executed to convey antagonism or revenge, and is not in reaction to a delusion or a fantasy; and the thieving is not better accounted for by behavior disorder, a manic episode, or antisocial personality disorder.

Skeptics have decried kleptomania as an invalid psychiatric concept exploited in legal defenses of wealthy lady shoplifters. During the twentieth century, kleptomania was strongly linked with the increased prevalence of department stores, and “department store kleptomanics” were a widely held social stereotype that had political implications.

Society and Culture

Stealing frequently becomes an obsession. Although people know they could get caught and marked for life, they find it hard to give up the habit. Major symptoms include a person’s decreased resistance to steal objects unnecessarily; feeling entitled to own them at any cost. Research says that if a person does get away with stealing like this, the heart-rate is known to increase, close to an adrenaline rush after committing a crime and getting  away with it.

Treatments for Kleptomania:

Anti-Seizure Medications:

Although originally intended for seizure disorders, these medications have shown benefits in certain mental health disorders, possibly including kleptomania. Examples include Topiramate and Valporic acid.

Addiction Medications:

Naltrexone, known  technically as an opioid anatagonist, blocks the part of the brain that feels pleasure with certain addictive behaviors. It may reduce the urges and pleasure associated with stealing.

We may have to try several different medications or combinations of medications to see what works best for us with the fewest side effects. Keep in mind that it may take several weeks to notice full benefits. Talk to a doctor or mental health  provider if we’re bothered by side effects . Under his or her guidance, we may be able to switch medications or change dosage. Many side effects eventually go away.

Psychotherapy treatment for kleptomania:

Cognitive behavioral therapy has become the psychotherapy of choice for kleptomania. In general cognitive behavioral therapy helps we identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. Cognitive behavioral therapy may include these techniques to help we overcome kleptomania urges. Covert sensitization, in which we picture our self-stealing and then facing negative consequences, such as being caught.

Aversion therapy, in which we practice mildly painful techniques, such as holding we breathe until we become uncomfortable , when we get an urge to steal.

Systematic desensitization , in which we practice relaxation techniques and picture our self controlling, urges to steal.

Other forms of therapy, such as psychodynamic therapy, family therapy or marriage counseling, also may be helpful.

Avoiding relapses:

It’s not unusual to have relapses of kleptomania. To help avoid relapses , be sure to stick to treatment plan. If we feel urges to steal , contact mental provider or reach out to a trusted support group.

Thanks,

Health-March-2013