September 15, 2011

Kleptomania, the impulsive and irresistible urge to steal, may have been described as early as 370 AD by St. Augustine when he wrote in Confessions “Yet I lusted to thieve and did it compelled by no hunger, nor poverty.” The term “kleptomania” is derived from the Greek words klepto meaning to steal and mania meaning insanity. Although kleptomania appears in the medical literature in the 19th century, current literature on the subject is limited.

Historically, kleptomania is an affliction associated with women. It gained widespread attention in the medical community in 19th century Europe. The rising status of medical science and the creation of the department store as a social arena for middle-class women were two strong influences on Victorian society’s perception of theft among women. Shopping was then viewed as the female’s natural arena and the department store offered women a place in urban society outside the home. Seen as the weak and unstable sex in that era, middle-class women were thought to be unable to control their shoplifting behavior due to the temptation of free access to merchandise the department store offered, in a way not previously known. Though the conception of kleptomania has changed and is now recognized in men as well as women, the ideas of the 19th century continue to influence contemporary views.

Kleptomania is currently understood by the medical community as a psychiatric disorder defined in the Impulse Control Disorders section of the Diagnostic and Statistical Manual of Mental Disorders-IV (Text Revision). The diagnostic criteria require that the affected individual exhibit a recurring failure to resist impulses to steal items, even though those items are not needed for personal use or for their monetary value. The individual also experiences a rising subjective sense of tension before the theft, and feels pleasure, gratification, or relief when committing the theft. Additionally, the stealing is not committed to express anger or vengeance, is not done in response to a delusion or hallucination, and is not better accounted for by another psychiatric disorder.

Kleptomania differs from criminal stealing in several important ways. In patients with kleptomania, the urge to steal is generally experienced as distinctly irresistible, intrusive, and often overpowering despite attempts to resist the urges. In addition, patients generally believe that stealing is wrong and most are embarrassed and ashamed of their behavior. The stealing is also often in response to emotional tension or anxiety which is relieved by the behavior. often, the stealing behavior is impulsive and abrupt rather than premeditated and has an involuntary quality.

Kleptomania is presumed to be a rare disorder. Studies of groups of shoplifters usually yield a low rate of kleptomania ranging from 0% to 8%. The shameful nature of the disorder presumably prevents people from reporting it; thus, an accurate assessment of its prevalence is difficult to estimate. The available studies consistently find that kleptomania is more common in women and often begins in adolescence or early adulthood. Though little is known about the natural course of the disorder, it may follow an episodic or chronic course.

The presence of other psychiatric disorders in those suffering from kleptomania is very common. Some of the most frequent co-occurring diagnoses are those that are also more common in women. Mood disorders such as depression and bipolar disorder are seen most frequently. other diagnoses include anxiety disorders such as obsessive-compulsive disorder, substance use disorders, and eating disorders such as anorexia nervosa and bulimia nervosa. The relationship between kleptomania and these other psychiatric disorders has been investigated in case studies. Individuals suffering from depression report that the act of stealing produces a “rush” or “high” that helps to temporarily alleviate their symptoms. Those diagnosed with anxiety disorders often reported a similar reduction in their anxiety after stealing.

The literature available on the treatment of kleptomania is limited. Case studies report some success with antidepressants such as Prozac and mood-stabilizing drugs such as lithium. Various forms of psychotherapy including behavioral therapy and psychoanalytic psychotherapy are found to be variably successful, but controlled studies are lacking. Some reports suggest that most people afflicted with kleptomania never seek formal treatment and simply disallow themselves to go shopping, thus avoiding the problem. Kleptomania is a diagnosis rooted in centuries of history but remains incompletely understood and infrequently studied in the modern medical community.

SEE ALSO: Anxiety disorders, Depression, Psychotherapy

Suggested Reading

  • Kaplan, H. I., & Sadock, B. J. (1997). Synopsis of psychiatry (8th ed.). Philadelphia: Lippincott, Williams & Wilkins.

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