Kleptomania
Primer
Kleptomania is characterized by the recurrent failure to resist impulses to steal items even though the items are not required for personal use or are of little value to the individual.
Epidemiology
The prevalence of kleptomania in the general population is very rare, and thought to be between 0.3 to 0.6%.
Females outnumber males at (3:1).
Kleptomania is estimated to occur in about 4 to 24% of individuals who are arrested for shoplifting.
Prognosis
The age at onset of kleptomania often begins in adolescence, but can develop at any stage.
Three typical courses of kleptomania have been described:
(1) Sporadic with brief episodes and long periods of remission
(2) Episodic with protracted periods of stealing and periods of remission; and
(3) Chronic with some degree of fluctuation.
The disorder may persist for years, despite multiple convictions for shoplifting.
Comorbidity
Comorbid disorders include compulsive buying, depressive disorders (particularly major depressive disorder), bipolar disorders, anxiety disorders, eating disorders (particularly bulimia nervosa), personality disorders, substance use disorders (particularly alcohol use disorder), and other disruptive, impulse-control, and conduct disorders.
Risk Factors
DSM-5 Diagnostic Criteria
Criterion A
Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.
Criterion B
Increasing sense of tension immediately before committing the theft.
Criterion C
Pleasure, gratification, or relief at the time of committing the theft.
Criterion D
The stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination.
Criterion E
Signs and Symptoms
Individuals typically attempt to resist impulses to steal, and they are aware that their acts are wrong and senseless. They may often feel depressed or guilty about the thefts.
The individual may hoard the stolen objects or secretly return them.
Individuals usually do not preplan the thefts or fully take into account the chances of apprehension (e.g. - being arrested), and the stealing is done without assistance from, or collaboration with, others.
Kleptomania Scales
| Name | Rater | Description | Download |
| Kleptomania Symptom Assessment Scale (K-SAS) | Patient | The K-SAS is a self-report scale consisting of 11 items designed to measure symptoms of kleptomania experienced in the last 7 days. | Link to original study trial |
Pathophysiology
Neurotransmitter pathways involving serotonin, dopamine, and the opioid system (the same ones associated with substance and behavioural addictions), are thought to play a role in kleptomania.
Differential Diagnosis
Ordinary theft
Kleptomania should be distinguished from ordinary theft or shoplifting. Ordinary theft (whether planned or impulsive) is deliberate and is motivated by the usefulness of the object or its monetary worth. Some individuals, especially adolescents, as an act of rebellion, may also steal on a dare, or as a rite of passage. The diagnosis is not made unless other characteristic features of kleptomania are also present. It is important to remember that kleptomania is exceedingly rare, whereas shoplifting is relatively common.
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Kleptomania should be distinguished from intentional or inadvertent stealing that may occur during a manic episode (e.g. - bipolar disorder), in response to delusions or hallucinations (e.g. - schizophrenia), or as a result of a major neurocognitive disorder (e.g. - frontotemporal dementia).
Investigations
Treatment
See also:
Durst, R., Katz, G., Teitelbaum, A., Zislin, J., & Dannon, P. N. (2001). Kleptomania. CNS drugs, 15(3), 185-195.
Resources
For Patients
For Providers
Articles
Research
1)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
2)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
3)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
4)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
5)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
6)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
7)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
8)
Grant, J. E., Kim, S. W., & Odlaug, B. L. (2009). A double-blind, placebo-controlled study of the opiate antagonist, naltrexone, in the treatment of kleptomania. Biological psychiatry, 65(7), 600-606.