Kleptomania DSM-5 Criteria

What is kleptomania?

Kleptomania involves the recurrent, uncontrollable urge to steal items, even when they are not needed for personal use or have no significant monetary value. Unlike ordinary theft, kleptomania is driven by a psychological compulsion rather than personal gain, with individuals experiencing a sense of tension immediately before committing the theft and pleasure or relief at the time of stealing. This behavior significantly disrupts daily life and causes distress or impairment in social, occupational, or other important areas of functioning.

The 2013 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies kleptomania under Disruptive, Impulse-Control, and Conduct Disorders, specifically as an impulse-control disorder. Individuals with kleptomania typically have comorbid psychiatric conditions, such as anxiety disorders, mood disorders, and major depressive disorder, which can complicate diagnosis and treatment. It is crucial to distinguish kleptomania from conduct disorders or antisocial personality disorder, as kleptomania is not motivated by antisocial tendencies, anger, or a desire for revenge.

While kleptomania is an impulse control disorder, it shares traits with addictive disorders (substance use, gambling) and obsessive-compulsive disorder.  Due to the high likelihood of psychiatric comorbidities, healthcare providers must evaluate the broader clinical picture, particularly when addressing repeated difficulties in resisting impulses.

Kleptomania DSM-5 Criteria

Risk factors for developing kleptomania include a family history of psychiatric disorders, traumatic events, and substance abuse, as well as personal experiences related to emotional regulation and impulse control.  Kleptomania can be diagnosed based on the criteria outlined in the DSM-5. The diagnostic criteria include:

A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.

B. Increasing sense of tension immediately before committing the theft.

C. Pleasure, gratification , or relief at the time of committing the theft.

D. The stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination.

E . The stealing is not better explained by conduct disorder, a manic episode, or antisocial personality disorder.

Given its complex nature and the potential for co-occurring conditions like bipolar disorder, substance use disorder, or depressive disorders, early diagnosis and intervention are crucial. The Kleptomania Symptom Assessment Scale is another diagnostic tool used to assess symptoms of kleptomaniac behaviors, supporting clinical professionals in understanding the severity and tailoring appropriate treatment plans.

Differences between the DSM-4 and DSM-5 criteria

The diagnostic criteria for kleptomania remain the same between the DSM-4 and DSM-5. However, in the DSM-5, kleptomania as an impulse disorder is now under the umbrella of Disruptive, Impulse-Control, and Conduct Disorders. This chapter consolidates disorders that were previously listed under Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence and Impulse-Control Disorders Not Otherwise Specified (where kleptomania was categorized in the DSM-4) (American Psychiatric Association, 1994; American Psychiatric Association, 2013).

How is kleptomania treated?

The following interventions are usually done in managing kleptomania:

Psychotherapy

Cognitive-behavioral therapy (CBT) is the primary treatment for kleptomania, helping individuals address distorted thoughts, develop impulse control, and reduce compulsive stealing. One technique that can be used is aversion therapy to manage urges.

Medications

Some medications, including antidepressants and drugs commonly used to reduce urges in individuals with addictions, may offer potential benefits for managing kleptomania. These medications are believed to help by addressing underlying mood disorders or impulsive behaviors often associated with the condition. However, it is essential to note that the Food and Drug Administration (FDA) has not approved any specific medication for treating kleptomania, and their effectiveness can vary widely among individuals.

Support groups

Peer support groups can provide a safe environment to share experiences, gain accountability, and build coping strategies.

Addressing co-occurring disorders

Treating coexisting mental health disorders, such as substance use disorders and major depressive disorder, is vital for comprehensive care. Managing these conditions can significantly reduce the symptoms of kleptomania.

Lifestyle modifications

Stress management techniques and identifying triggers can improve impulse control and reduce compulsive behaviors over time.

By combining these methods, individuals with kleptomania can achieve improved impulse control, reduce the risk of legal consequences, and enhance overall well-being.

References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). American Psychiatric Association.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Pearson.