Kleptomania is a psychological disorder classified as an impulse control disorder. It describes the inability to resist the urge to steal objects of no monetary value or need for personal use. Kleptomania typically begins in adolescence and can persist into late adulthood in some cases. Its rarity and the fear of social stigma limit treatment seeking, making it difficult to accurately determine its prevalence.

Individuals with kleptomania often hide stolen items, or sometimes leave them behind. This suggests that the urge to steal may come and go, or become less or more intense over time. In some cases, stolen items may be donated or given as gifts to family members or friends.

Studies have shown that between 3.8% and 10% of thieves have kleptomania. Given these rates, kleptomania is not considered a common disorder.

It's important to seek professional help for the treatment of kleptomania. Psychotherapy, particularly cognitive behavioral therapy, can be effective in treating kleptomania. Professionals can help patients control their impulses and understand potential causes. The treatment process can vary for each individual, and professional support is crucial for beginning treatment.

What are the risk factors for kleptomania?

There are some risk factors that are effective in the emergence of kleptomania:

• Family history: Kleptomania can increase the risk of developing the disorder if family members have similar disorders (for example, kleptomania or obsessive-compulsive disorder).
• Other psychological disorders: People with kleptomania often have other psychological disorders. Conditions such as bipolar disorder, anxiety disorder, eating disorder, substance use disorder, or personality disorder may increase the risk of developing kleptomania.
• Adolescence and youth: Kleptomania typically begins in adolescence or young adulthood. However, in some cases, it can begin in adulthood or later.

These factors may influence the development of kleptomania, but they can vary from person to person. While the exact causes of kleptomania are not fully understood, these factors are thought to increase the risk. In such cases, it is important to seek professional help and implement appropriate treatment methods.

What are the symptoms of kleptomania?

• Stealing without need: A strong urge to steal items that are not needed and an inability to control this urge.
• Emotions experienced when the urge occurs: When the urge to steal occurs, there is usually a feeling of tension, anxiety, or arousal.
• Pleasure from stealing: Feelings of pleasure, relief, or satisfaction during the act of stealing.
• Negative feelings afterward: Feelings such as regret, self-blame, shame, or fear of arrest after the theft.
• Relapse of impulses and repetition of the cycle: These symptoms may occur periodically, and the cycle may repeat itself. The person may have difficulty coping with the urge to steal and may be unable to suppress the urge.

These symptoms are typical of kleptomania and can vary from person to person. To diagnose kleptomania, these symptoms must be persistent, distressing, negatively impact daily life, and professional help is necessary. When observing such symptoms, it may be helpful to consult a psychiatrist or therapist.

How is kleptomania diagnosed?

Diagnosis of kleptomania is usually based on symptoms and signs and is made by a psychiatrist or specialist physician. Diagnostic methods may include:

• Interview and observation: The physician may conduct a detailed interview to understand the patient's symptoms and identify situations, emotions, or thoughts that may trigger stealing. They may also observe the patient's emotional state, behavior, and frequency of stealing.
• Mental health assessment: A psychologist or psychiatrist may use specialized tests, assessment tools, and self-assessment forms to assess a patient's overall mental health. This can help identify other psychological conditions besides kleptomania.
• DSM-5 criteria: The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifies diagnostic criteria for kleptomania. Based on these criteria, a physician attempts to make a diagnosis by evaluating the patient's symptoms, signs, and behaviors.
• Physical exam and lab tests: A physical exam may be performed to identify any underlying medical conditions that could be contributing to the symptoms. This can help determine if another underlying medical condition is causing the stealing behavior.

Based on a patient's symptoms and an assessment based on DSM-5 criteria, a diagnosis of kleptomania is made. This diagnostic process involves considering a variety of factors and conducting a thorough assessment.

How is kleptomania treated?

The treatment of kleptomania remains an area of ​​insufficient research and evidence. A significant challenge in treating kleptomania is treatment-resistant patients. Difficulties in initiating treatment include the lack of detectable kleptomania and the long timeframe for treatment. Patients whose kleptomaniac behaviors continue to mask other symptoms can hinder treatment progress and reduce treatment success.

Kleptomania often presents with other comorbid conditions, such as mood disorders. Therefore, patients often seek treatment for other comorbid conditions that bother them rather than for kleptomania. Stealing behavior can be associated with other problems, such as depression, anxiety, and identity issues.

Treatment may include serotonin reuptake inhibitors (SSRIs), mood-stabilizing medications, and medications that regulate impulse control. Psychotherapeutic approaches such as cognitive-behavioral therapy are also used. Some research suggests that cognitive-behavioral therapy combined with medication may be more effective than medication alone.

Treatment for kleptomania requires an individualized approach, and the treatment plan should be developed considering the patient's symptoms, comorbidities, and response to treatment. Seeking professional help and collaborating with a specialized psychiatrist or therapist is crucial throughout the treatment process.

• Psychodynamic Approaches: The primary goal of psychodynamic therapies is to access the individual's subconscious, identify the underlying motivations for their behavior, and assist the patient in changing their behavior. Psychoanalysis requires a lengthy treatment process, and the results of kleptomania are controversial. The effectiveness of psychodynamic therapies is unclear due to insufficient long-term follow-up information and the lack of controlled studies.
• Behavioral therapies: While there are insufficient studies in the literature on the effectiveness of cognitive-behavioral therapies in treating kleptomania, they have been observed to be successful in impulse control disorders, especially when used in conjunction with medication. These therapies aim to correct inaccurate thoughts, improve stress-coping skills, and prevent relapses by inducing avoidance behaviors.
• Covert sensitization technique: This technique involves associating the desire to steal with imagined stealing behaviors, making the individual aware of the consequences of stealing. This technique may be linked to the individual's fear of being caught or punished.
• Pharmacological treatment: Treatment for kleptomania generally includes psychotherapy and medication. While there is no specific FDA-approved medication for kleptomania, some medications can be used in the treatment of kleptomania. For example, naltrexone, a medication that can reduce the effects of opioids, can be used to reduce urges in kleptomania. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are among the preferred medications for treating kleptomania.

Why does kleptomania occur?

Kleptomania can have different causes:

• Serotonin levels: Low levels of the neurotransmitter serotonin in the brain can be observed in people with impulse control disorders. This condition is associated with a lack of serotonin, which regulates mood and emotions.
• Addictive disorders: Stealing can cause the release of a neurotransmitter called dopamine. Dopamine provides feelings of reward and satisfaction, and some people tend to re-experience these feelings.
• Opioid system disorders: Urges are regulated by the opioid system in the brain. An imbalance in this system can hinder the ability to resist impulses.

Is stealing behavior in children a sign of kleptomania?

In children, the act of taking without permission may occur because they are young and don't yet fully grasp the concept of property. This doesn't necessarily mean the child is a kleptomaniac.

There can be various reasons behind children stealing. For example, an overly disciplinarian parent, comparing their child to other children, or providing criticism or negative feedback can all lead to this behavior. Additionally, factors such as family tension and violence can also motivate a child to steal. These situations are often related to the child's emotional state or environmental factors.