![]() 1, 4, 9 Desensitization was effective in a small study of three patients with impulse control disorders: two shop-lifters and one binge eater. Various psychotherapeutic techniques alone and in combination with psychotropic medications have been reported to improve compulsive stealing. Kleptomania has also been reported as paradoxical side effect of SSRIs in three patients. 19 Brain disorders, such as epilepsy 17 and frontotemporal dementia 1 have been reported to cause kleptomania. 18 New onset kleptomania has been reported in two cases of closed head trauma. Impulse control disorders can present as neuropsychiatric sequelae of head trauma and traumatic brain injury. 16, 17 Additionally, there are case reports in the literature documenting kleptomania responding to lithium, valproate, trazodone, and electroconvulsive therapy. 15 Again, this has been extrapolated to kleptomania with encouraging results in small case series. 14 Topiramate, an anticonvulsant drug, has been shown to be effective in impulse control disorders, and recently topiramate demonstrated efficacy in treating binge eating. 11 – 13 A double-blind, placebo-controlled study of 25 patients who were administered naltrexone showed significant improvement in kleptomania. 8 Naltrexone, an opiate antagonist used to treat addictive behaviors, has been shown to reduce kleptomania symptoms. Kleptomania may also be regarded as a form of addictive behavior and has been shown to be associated with other substance use disorders (e.g., alcohol and nicotine). ![]() 6, 9 Reports of kleptomania responding to selective serotonin reuptake inhibitors (SSRIs) suggests a common pathophysiology with mood and anxiety disorders. The disorder appears to be highly associated with mood disorders and anxiety spectrum disorders. 1, 4 Neuropsychiatric factors are also thought to play a role in kleptomania. 1, 4 Kleptomania has also been linked to psychosexual issues such as sexual repression and suppression. Psychoanalytic theories link compulsive stealing to childhood trauma and neglectful or abusive parents, and stealing may symbolize repossessing the losses of childhood. The pathophysiology of kleptomania is unknown. The patients with kleptomania were also found to have high rates of substance abuse and mood disorders. The patients with kleptomania had significantly higher levels of impulsivity that distinguished them from both comparison groups. ![]() 7 A report that identified 11 patients with kleptomania compared them to a group of patients with alcoholism and to a group of non-psychotic psychiatric patients. In a study of 204 psychiatric patients admitted for inpatient treatment, 31 percent of the patients were identified with a current impulse control disorder and 7.8 percent with kleptomania. Kleptomania and other impulse control disorders seem to be more prevalent among those with psychiatric disorders. All of the patients in the study had a lifetime diagnosis of depression 16 had a lifetime diagnosis of an anxiety disorder and 12 had a lifetime diagnosis of an eating disorder. 4Ī study involving 20 kleptomania patients found a high association with major depression and, to a lesser extent, anxiety and eating disorders. Men are more likely to be sent to prison instead of being referred to treatment. Patients usually present for treatment by legal mandate due to repeated shoplifting. Kleptomania is rarely brought to medical attention voluntarily. The onset is usually in adolescence, and the average age for presentation for treatment is 35 years for women and 50 years for men. The female to male ratio is estimated at 3:1. In those arrested for shoplifting, the prevalence of kleptomania is 3.8 to 24 percent. The prevalence of kleptomania in the general population is approximated at 0.6 percent.
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