Updated: 6/29/2020

Kleptomania

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Snapshot
  • A 32-year-old woman with a history of bulimia nervosa presents to the psychiatry clinic after being arrested for shoplifting.  She stole a necklace from the department store, though she admits that she did not need it. She reports an uncontrollable urge to steal even though she has no financial difficulties. While stealing, she feels a resolution of the urge and a surge of gratification but after the theft, she feels a sense of shame and remorse.
Introduction
  • Overview 
    • kleptomania is the inability to resist the urge to steal items that may not be necessary nor valuable to the person
  • Epidemiology
    • incidence
      • ~6 per 1000 people
      • estimated to account for ~5% of shoplifting
    • demographics
      • female:male ratio is ~3:1
      • age of onset is usually in adolesence
  • Pathophysiology
    • unknown cause
  • Associated conditions
    • family history
      • higher rates of obsessive-compulsive disorder and substance use disorders in relatives of people with kleptomania have
    • psychiatric comorbidity (i.e. major depressive disorder, anxiety disorder, eating disorder, or alcohol use disorder)
Presentation
  • Symptoms 
    • inability to resist powerful urges to steal items that one does not need
    • rising sense of tension leading up to theft
    • pleasure, relief, or gratification while stealing
    • guilt, remorse, shame, or fear after theft
Treatment
  • Lifestyle
    • cognitive behavioral therapy
      • involves techniques to help control kleptomania urges
  • Medical
    • naltrexone
      • opioid antagonist
      • may ↓ urges and pleasure associated with stealing
    • selective serotonin reuptake inhibitors
      • may be indicated if patient also has depression
Complications
  • Severe emotional, family, work, and financial problems
    • may result in depression, eating disorders, and anxiety

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