CASE STUDY

Kleptomania (also spelled cleptomania) (Greek: κλέπτειν, kleptein, "to steal", μανία, "mania") is the condition of not being able to resist the urge to collect or hoard things. People with this disorder are compelled to steal things, generally objects of little or no significant value, such as pens, paper clips, tape, traffic cones, signs, and small toys. Some kleptomaniacs may not even be aware that they have committed the theft.

Kleptomania was first officially recognized in the US as a mental disorder in the 1960s in the case of the state of California v. Douglas Jones.

Kleptomania is distinguished from shoplifting or ordinary theft, as shoplifters and thieves generally steal for monetary value, or associated gains and usually display intent or premeditation, while Kleptomaniacs are not necessarily contemplating the value of the items they steal or even the theft until they are compelled. Of all reported shoplifting, less than 5% are actually committed by kleptomaniacs.

This disorder usually manifests during puberty and, in some cases, may never stop and lasts throughout the person's life.

People with this disorder are likely to have a comorbid condition, specifically paranoid, schizoid or borderline personality disorder.Kleptomania can occur after traumatic brain injury and carbon monoxide poisoning.

Kleptomania is usually thought of as part of the obsessive-compulsive disorder spectrum, although emerging evidence suggests that it may be more similar to addictive and mood disorders. In particular, this disorder is frequently co-morbid with substance use disorders, and it is common for individuals with kleptomania to have first-degree relatives who suffer from a substance use disorder.

Kleptomania has several different treatments. Cognitive-behavioral therapy is recommended as an adjuvant to medication.

Some medications that are used for people diagnosed with kleptomania are selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists.The only open-trial of medication for kleptomania showed naltrexone significantly reduced the intensity of urges to steal, stealing thoughts and stealing behavior.A similar three year follow-up of patients treated only with naltrexone showed a clinically significant reduction in kleptomanic behavior.

Doctors in the US have been treating diagnosed kleptomaniacs with mood-altering drugs such as Prozac and Seroxat, on the presumption that outbursts could be triggered by changes in the levels of serotonin in the brain, much like depression. Psychological counselling, to get at the underlying causes of unhappiness, is more likely to effect a long-term cure. Discussing the disorders with others with the same condition was also noted to help.

Kleptomania is frequently thought of as being a part of obsessive-compulsive disorder, since the irresistible and uncontrollable actions are similar to the frequently excessive, unnecessary and unwanted rituals of OCD. Some individuals with kleptomania demonstrate hoarding symptoms that resemble those with OCD.

Prevalence rates between the two disorders do not demonstrate a strong relationship. Studies examining the comorbidity of OCD in subjects with kleptomania have inconsistent results, with some showing a relatively high co-occurrence (45%-60%) while others demonstrate low rates (0%-6.5%).Similarly, when rates of kleptomania have been examined in subjects with OCD, a relatively low co-occurrence was found(2.2%-5.9%).

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