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Seniors Choice NewsMagazine Kleptomania By Dr. Paul Latimer We have all seen media coverage in the past where a celebrity or politician who is respected in their community gets caught for shoplifting or some other theft related crime. Sometimes these individuals claim their theft was brought on by stress and these claims spur much speculation about the idea of an irresistible urge to steal. Many people wonder if it is possible for a normally honest person to be driven to theft by stressful events or an illness. Should such a person be able to avoid criminal charges because of apparent remorse? Without any specific case in mind, I would like to spend some time discussing an obscure disorder involving theft – kleptomania. Kleptomania is a psychiatric disorder that is formally recognized by the Amercian Psychiatric Diagnostic and Statistical Manual. The disorder is said to exist in a person when stealing is out of character and performed impulsively rather than for personal gain. This disorder involves a recurrent, uncontrollable impulse to steal and may seem to occur during an altered state of consciousness. The impulse to steal is similar to compulsions performed by a person with obsessive compulsive disorder because the person with kleptomania feels increasing tension and anxiety related to stealing. These feelings of anxiety are relieved when he or she commits the theft. Unlike non-disordered people who steal, the kleptomaniac is not stealing for pleasure, but to relieve discomfort. Usually, the kleptomaniac steals objects that are not needed for personal use or for their monetary value. Stealing is also not committed to express anger or vengeance. In fact, people with kleptomania realize that stealing is wrong and they experience conflict about their theft. This disorder is likely the extreme end of a continuum of stealing behaviour that includes many cases of shoplifting that would not meet all of these criteria but are also not obviously typical, profit-motivated stealing. There is thought to be some relationship between levels of stress or depression and stealing. In fact, kleptomaniacs frequently experience other psychiatric disorders as well. Most common are depression and or anxiety disorders, but other impulse control disorders such as OCD are also more common in kleptomaniacs than in the general population. Stealing is also particularly common in the eating disorder bulimia but not in anorexia nervosa without bulimia. One study found that individuals with kleptomania have much higher levels of perceived stress than most people. The same study found that the amount of perceived stress decreased as the disorder was treated. Other research suggests that the tension relief associated with kleptomanic stealing may provide antidepressant effects for the individual and some with co-existing depression might use stealing as a form of self-medication. Treatment for kleptomania is usually directed at treating the co-existing psychiatric disorders. For example, if the individual experiences depression as well as kleptomania, the depression would be treated directly. Often, treating the other disorders greatly improves the kleptomania as well. It is thought by some to be an “affective spectrum disorder” and responds to the same medications as bulimia, obsessive-compulsive disorder, and trichotillomania. Serotonin re-uptake inhibitors are particularly effective at improving impulse control as well as mood symptoms. If the individual is experiencing stress related to life problems, these can be dealt with in psychotherapy. Finally, it is possible for theft to occur as an uncharacteristic action that cannot be easily controlled. In these cases, the individual often feels a great deal of remorse for his or her actions and should seek the advice and treatment of a therapist. This does not necessarily mean they should avoid legal consequences for their actions, which is a matter for the courts to decide. Dr. Latimer, president of Okanagan Clinical Trials and local psychiatrist, can be reached at (250) 862-8141 or by email at [email protected]. http://www.seniorschoice.com Powered by Joomla! Generated: 27 October, 2016, 01:19