Kleptomania: Symptoms, Diagnosis, and Treatment

Definition

Kleptomania (not "cliptomaniac") is an impulse control disorder (DSM-5: 312.32) characterized by recurrent failure to resist urges to steal items not needed for personal use or monetary value.

Diagnostic Criteria (DSM-5)

1. Recurrent stealing of unneeded objects.
2. Increasing tension immediately before the theft.
3. Pleasure, gratification, or relief at the time of the theft.
4. Stealing not due to anger, vengeance, delusion, or hallucination.
5. Not better explained by conduct disorder, mania, or antisocial personality disorder.

Clinical Features

• Onset often in adolescence; more common in females.
• Stolen items often hoarded, discarded, or secretly returned.
• High comorbidity: mood disorders, anxiety, OCD, eating disorders, substance use.
• Significant shame, guilt, legal consequences.

Treatment

• Psychotherapy: CBT (cognitive restructuring, urge surfing, relapse prevention), psychodynamic therapy.
• Medications: SSRIs (fluoxetine, sertraline) – some evidence; naltrexone (opioid antagonist) – reduces urge; mood stabilizers (topiramate, valproate) – case reports.
• Support groups: 12-step (e.g., Kleptomaniacs and Shoplifters Anonymous).

Key Distinction

Kleptomania ≠ ordinary shoplifting (planned, for gain). It is driven by irresistible impulse and emotional dysregulation.