Kleptomania is an impulse control disorder. People with kleptomania experience irresistible impulses or urges to steal. Stealing without regard for the value of an object and taking unnecessary items are features of the disorder. Prior to stealing, patients feel increasing anxiety until the impulse to steal becomes overwhelming. After stealing, they feel relief and gratification. Individuals with this disorder believe the only way to achieve this emotional release is by acting on the impulse to steal.
Feelings of anxiety, depression and guilt are common in people with kleptomania. There are a number of mental disorders that may coexist in patients with kleptomania, including major depression, obsessive-compulsive disorder(OCD) and bulimia nervosa.
Kleptomania is a rare mental disorder. According to the American Psychiatric Association(APA), less than 5 percent of identified shoplifters have kleptomania. It is more common in women than in men and can develop at any point in a person’s life, although appearance during adolescence may be more typical. Once kleptomania appears, it can recur throughout a person’s life unless treated. The causes of kleptomania are not fully understood.
It is hard to identify a person with kleptomania. Individuals with the condition are often reluctant to admit to the illegal activity for fear of criminal prosecution. Stealing is completed alone and the stolen objects are hidden, discarded, given away or returned. Kleptomania often goes undetected until a person is caught stealing. Accurate diagnosis of this disorder can be difficult. There are a number of mental disorders that can include stealing behavior and are sometimes confused with kleptomania. These include antisocial personality disorder, bipolar I disorder, conduct disorder, schizophrenia, substance abuse and dementia. Careful review of a patient’s signs and symptoms is necessary for an accurate diagnosis. Treatment for kleptomania can include medications, psychotherapy or a combination of both.
Kleptomania is an impulse control disorder characterized by the urge to steal, regardless of economic need. People with kleptomania do not need or use the objects they steal. They often have the money necessary to purchase the stolen items and may discard or give away the items after stealing them. Some secretly hoard or return the stolen items.
Important components of kleptomania include feelings of tension and release surrounding the act of stealing. Typically, kleptomania involves an increasing urge, or tension, to steal. The impulse is so strong that a person with kleptomania believes the only way to achieve emotional release is to steal. Once an object has been stolen, there is a noticeable sense of relief, pleasure or gratification. People with kleptomania may also feel remorse or guilt about their actions.
It is important to distinguish between kleptomania and ordinary acts of theft, such as shoplifting. Shoplifting may be impulsive or planned, but it is deliberate and motivated by profit. People who shoplift may steal for the thrill of it, on a dare or out of anger. Patients with kleptomania do not generally plan the theft in advance, take items of little or no value and are remorseful, but feel unable to stop.Kleptomania is rare and applies to less than 1 out of every 20 shoplifters, according to the American Psychiatric Association (APA). It may first appear in childhood, adolescence or adulthood. Kleptomania rarely occurs for the first time among older adults. Once it appears, it tends to be chronic. However, periods of remission with no impulse to steal are common. Kleptomania appears to occur more often among women than men and can last a lifetime unless treated. Kleptomania may lead to serious personal, career and legal complications, including arrest and jail.
Risk factors and causes of kleptomania
Gender seems to play a role in the development of kleptomania since women are more likely to be affected than men. According to the American Psychiatric Association(APA), two-thirds of people with kleptomania in clinical trials have been women. This gender difference may be complicated by additional factors, such as differences in socially approved behavior (women may be more likely to seek help for their behavior than men) and misdiagnosis (men may be more likely to be diagnosed with antisocial personality disorder rather than kleptomania).
It is difficult to know which other factors may increase a person’s risk of developing the disorder since the causes of kleptomania are not fully understood. For example, the disorder may first appear at any time in a person’s life – in childhood, adolescence or adulthood (although rarely in old age). However, studies have indicated that early onset, beginning in the teen years, may be more typical. It is unknown whether family history is related to kleptomania.
Anxiety, guilt and depression are often found in people with kleptomania. Depressive episodes may occur prior to the act of stealing and stress or anxiety may act as a trigger for episodes. In general, people with kleptomania can have problems with impulsive or compulsive behavior, such as impulse stealing or compulsive buying.
The following disorders may coexist in a person with kleptomania:
- Major depression. Severe depression that is long-lasting and disabling.
- Dysthymic depression. Mild, chronic depression, with symptoms that last at least two years.
- Generalized anxiety disorder(GAD). Chronic, excessive worry or fear that occurs without any known cause.
- Obsessive-compulsive disorder(OCD). Patterns of recurrent thoughts or feelings, followed by behaviors a person feels compelled to perform.
- Bulimia nervosa. Patterns of eating binges followed by efforts to purge food from the body to avoid weight gain. Medications such as laxatives or behaviors such as vomiting may be used to accomplish this.
- Substance abuse. Chronic use of a substance that alters mood or behavior and causes disruption in a person’s life.
Signs and symptoms of kleptomania
The signs of kleptomania may be difficult to identify. Patients with this impulse control disorder may later hide the stolen objects. Because theft is a crime, they are often reluctant to admit the behavior for fear of criminal prosecution.
Patients with kleptomania are often not identified until they are caught stealing. However, there are some signs and symptoms that can indicate a person may have kleptomania. They include:
- Strong urge to steal
- Building anxiety or tension prior to stealing
- Sense of relief after stealing
- Obsessions with stealing
- Stealing on impulse, without planning ahead
- Stealing when alone
- Stealing objects that are not valuable, not necessary or will not be used
- Discarding or giving away stolen objects
- Secretly hoarding stolen objects
- Returning stolen items
- Being held or questioned about shoplifting
- Arrests for shoplifting or theft
Diagnosis methods for kleptomania
An evaluation by a physician (e.g., psychiatrist) or a non-psychiatrist mental health professional is necessary to determine whether or not a person has kleptomania. A patient’s social history, including a history of any legal problems, can also help identify signs of the disorder.
The American Psychiatric Association (APA) has developed specific criteria to help determine whether a person has kleptomania. For a diagnosis of kleptomania, all of the following must occur:
- Repeatedly giving in to an impulse to steal objects without regard for their financial value or practical use
- Feelings of increasing tension prior to the act
- Feelings of pleasure or relief after the act
- Stealing without feelings of anger or revenge, nor in response to delusions or hallucinations
- Stealing that is not better explained by another mental disorder
Kleptomania can sometimes be confused with other mental disorders, making accurate diagnosis difficult. For example, stealing is the most noticeable sign of kleptomania, but it may also indicate a number of other mental health conditions. Careful evaluation of a patient’s signs and symptoms can help identify the appropriate disorder.
Kleptomania is sometimes confused with the following disorders:
- Antisocial personality disorder. Features impulsive, deceitful behavior such as stealing. People with this disorder display a general pattern of antisocial behavior, in addition to incidents of stealing, and exhibit no guilt or remorse for their actions.
- Bipolar I disorder. A condition characterized by alternating periods of depression and mania, during which impulsive stealing can occur. Stealing that occurs during a manic episode is not a sign of kleptomania, according to APA diagnostic criteria.
- Conduct disorder. A condition in which young people perform repetitive, antisocial acts that harm others, including stealing. Like antisocial personality disorder, this type of stealing can be distinguished from kleptomania by the presence of a larger pattern of antisocial behavior.
- Schizophrenia. Characterized by difficulty determining the real from the unreal. People with schizophrenia may have hallucinationshallucinations that prompt them to steal. According to the diagnostic criteria, stealing cannot be considered kleptomania if it is in response to hallucinations.
- Substance abuse. A disorder marked by the use of a substance (e.g., alcohol, drugs) that alters mood or behavior and causes significant distress or harm in one’s life. People with substance abuse may steal to support a drug or alcohol habit or due to a lack of inhibitions resulting from the substance use. This differs from kleptomania in which patients steal without regard for financial gain or personal use.
- Dementia. The progressive loss of intellectual functioning, sometimes accompanied by hallucinations or delusions. Inadvertent or intentional stealing may occur with this disorder but is not considered a sign of kleptomania.
Kleptomania may also be confused with malingering, faking symptoms of a disorder for some type of personal gain. People who steal may pretend to have the symptoms of kleptomania as a way to avoid criminal prosecution for theft.
Treatment options for kleptomania
Treatment for kleptomania can include medication, therapy or a combination of the two. However, there are few controlled studies on any of the treatments for kleptomania. Therefore, it is difficult to state with any degree of certainty how useful they are for people who suffer from this disorder.
Some research indicates that antidepressant medications may be beneficial for the treatment of kleptomania in some patients. The medication naltrexone may also be effective in treating kleptomania. Used to treat opioid and alcohol addiction, naltrexone blocks the rush or “high” feeling that can make these addictions pleasurable.
Psychotherapy can occur in one-on-one or group settings. Types of psychotherapy used to treat kleptomania may include:
- Behavior therapy. Focuses on changing undesired behaviors through rewards. Desensitization is a type of behavior therapy that can be especially helpful to patients with kleptomania. It involves repeated exposure to environments (such as a store) that may trigger stealing, while in a relaxed state. This can help control the urge to steal by lessening the tension that precipitates the act.
- Cognitive behavior therapy(CBT). Explores the link between thoughts and actions. This method can help a person with kleptomania understand that the impulse to steal will pass, and that stealing is not the only way to reduce the impulse.
- Family therapy. Explores problems with regard to the patient’s personal relationships. This can help identify relationship stressors that may contribute to kleptomania.
Questions for your doctor about kleptomania
Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients and their family and friends may wish to ask the doctor the following kleptomania-related questions:
- Do you have experience treating kleptomania or other impulse control disorders?
- I occasionally steal. Do I have kleptomania?
- Will being diagnosed with kleptomania keep me from going to jail if I am caught stealing?
- Can I learn to resist the impulse to steal? Will I need medication or therapy to help me do this?
- What types of medications should I take, and what are their side effects?
- What type of psychotherapy may be appropriate for me?
- Can you recommend a therapist, mental health professional, support group or other setting that may benefit me?
- How long will I need to receive treatment for my kleptomania?
- What side effects of treatment or behaviors do you want me to immediately report to a physician or therapist?
- If treatment is successful, what is the risk of future recurrence? What can I do to reduce that risk?