Kleptomania

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.

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.

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. Kleptomania can occur after traumatic brain injury and carbon monoxide poisoning.

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.

Diagnosis
The DSM-IV-TR lists the following five criteria for kleptomania:


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


 * Increasing sense of tension immediately before committing the theft.


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


 * The stealing is not committed to express anger or revenge and is not in response to a delusion or a hallucination.


 * The stealing is not better accounted for by conduct disorder, a manic episode, or antisocial personality disorder.

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

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. .

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%) while others demonstrate low rates (0%-6.5%). Similarly, when rates of kleptomania have been examined in subjects with OCD, a relatively low co-occurrence was found(2.2%-5.9%).