Pyromania

Pyromania is an impulse-control disorder, characterized by multiple episodes of deliberate and purposeful fire setting associated with tension or affective arousal.^[1]

• The prevalence of pyromania is not known.^[2]
• The lifetime prevalence of fire setting (not pyromania and not sufficient for a diagnosis by itself) is estimated to be 1.1%.^[3]
  • In one study of a criminal system population of repeat fire setters, only about 3% had symptoms that met full criteria for pyromania.^[4]
• It is much more common in males.^[5]

• The typical age of onset of pyromania is not known.
• Fire-setting incidents are episodic and may wax and wane in frequency.^[6]

• Individuals who impulsively set fires (whether not they have pyromania) often have a current or past history of alcohol use disorder.^[7]
• The most common comorbidities in fire-setting individuals (not specifically a pyromania diagnosis) are antisocial personality disorder, impulse-control disorders, substance use disorders, bipolar disorder, and gambling disorder.^[8]
• Juvenile fire setting is usually associated with other disorders, including conduct disorder, attention-deficit/hyperactivity disorder (ADHD), or an adjustment disorder.^[9]

Deliberate and purposeful fire setting on more than 1 occasion.

Tension or affective arousal before the act.

Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts (e.g. - paraphernalia, uses, consequences).

Pleasure, gratification, or relief when setting fires or when witnessing or participating in their aftermath.

The fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances, in response to a delusion or hallucination, or as a result of impaired judgment (e.g. - major neurocognitive disorder, intellectual disability, substance intoxication).

The fire setting is not better explained by conduct disorder, a manic episode, or antisocial personality disorder.

• Individuals may make considerable preparations for starting a fire.
• There is often an indifference to the consequences to life or property caused by the fire.^[10]
• In pyromania, individuals experience tension or affective arousal before setting a fire
• They may be regular “watchers” at fires in their neighbourhoods, may set off false fire alarms.
• In some cases, they may derive pleasure from institutions, equipment, and personnel associated with fire (e.g. - spend time at local fire department, or even become fire fighters).^[11]

• Fire Setting Scale^[12]
• Fire Proclivity Scale^[13]
• St Andrews Fire and Risk Instrument (SAFARI)^[14]

• Other causes of intentional fire setting
  • Many other causes of fire setting exist, and are more likely than a diagnosis of pyromania. For example, intentional fire setting may occur for profit, sabotage, or revenge; to conceal a crime; to make a political statement (e.g. - protest, or an act of terrorism); or to attract recognition (e.g. - setting a fire in order to discover it and “save the day”).
  • Fire setting can also occur as part of developmental experimentation in childhood (e.g. - playing with matches or fire).
• Other mental disorders
  • A separate diagnosis of pyromania is not given when fire setting occurs as part of conduct disorder, a manic episode, or antisocial personality disorder, or if it occurs in response to a delusion or a hallucination (e.g. - in schizophrenia) or is due to physiological effects of another medical condition (e.g. - epilepsy). Pyromania is also not diagnosed when the fire setting is from impaired judgment due to a major neurocognitive disorder, intellectual disability, or substance intoxication.^[15]