10 Things Everyone Should Understand About Kleptomania

Source: Lisa-S/Shutterstock

Kleptomania has been formally described in the literature for about 200 years. Nevertheless, it is poorly appreciated, with little data examining its pathology or treatment.

Although the lifetime prevalence of shoplifting in the United States is 11.3%, it’s likely that far fewer people actually have kleptomania. Here are 10 other evidence-based findings about kleptomania based on recent research.

1. The DSM-V classifies kleptomania as an impulse control disorder, and it has been classified as such since the DSM-III. Nevertheless, this condition shares characteristics with obsessive compulsive spectrum disorders (OCD), mood disorders, and substance abuse disorders.
2. Kleptomania is typified by urges to steal and the inability to stop, which can be impulsive. These urges are premature, poorly conceived, risky, and dangerous. Some testing has demonstrated that people with this condition are more impulsive and less inhibited, as well as sensation seeking. People with the illness experience intrusive thoughts and urges associated with shoplifting, and often feel guilt, remorse, or depression after the act. The items that they steal are typically unwanted/unneeded and are hoarded, discarded, given away, or returned to the store. Suicide attempts linked to feelings of shame over shoplifting or associated personal problems are not uncommon.
3. According to the authors of a study in the Annals of Clinical Psychiatry, the severity of a kleptomania diagnosis was strongly correlated with feeling a “reward” from stealing, as well as comorbid compulsivity disorders such as OCD and anorexia nervosa. They wrote, “Treatment approaches should incorporate these as possible treatment targets. These data may also support conceptualization of kleptomania as an obsessive-compulsive related disorder rather than being allied to substance use or impulsive disorders.”
4. As with OCD, exposure and response prevention (ERP), a form of cognitive-behavioral therapy (CBT), has been suggested to be effective in the treatment of kleptomania.
5. Medications that may be effective in the treatment of kleptomania include SSRIs and opioid antagonists such as naltrexone.
6. In the literature, a few cases have highlighted kleptomania as an adverse effect of venlafaxine administration. Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI), and experts hypothesize that kleptomania secondary to venlafaxine administration could be due to heightened dopaminergic activity. On a related note, shoplifting commonly occurs in patients with Parkinson’s disease during prodopamine administration.
7. Kleptomania induced by antidepressants usually appears abruptly and during the euthymic state following the remission of depression.
8. Kleptomania takes an emotional and legal toll. Between 64% and 87% of kleptomania patients have been arrested, with between 15% and 23% incarcerated.
9. In a 2015 Maine Supreme Court Case, a defense of “not guilty by reason of insanity” due to kleptomania was unsuccessful.
10. Some experts suggest that diversion from the criminal justice system to court-mandated treatment may be appropriate and cost-saving.

People with kleptomania struggle greatly with the condition. Although much remains to be elucidated regarding kleptomania, emerging psychotropic and psychotherapeutic interventions may help those with the condition. In the meantime, they would likely benefit more from compassionate treatment instead of legal repercussions.