Kleptomania

What kleptomania involves

The DSM-5-TR describes kleptomania as:

• repeated failure to resist impulses to steal objects that are not needed for personal use or their monetary value
• increasing tension immediately before the theft
• pleasure, gratification or relief at the time of the theft
• stealing that is not done to express anger or revenge, and not in response to delusions or hallucinations
• stealing not better explained by conduct disorder, a manic episode or antisocial personality disorder

People with kleptomania often steal from stores, but also from friends, family or work. The stolen items are frequently of little value and may be given away, returned secretly, hoarded or discarded.

Kleptomania vs shoplifting

Most people who shoplift do not have kleptomania.

Causes and risk factors

The cause is not fully understood. Suggested contributors include:

• differences in brain systems involving serotonin, dopamine (reward) and opioid pathways, similar to addictions
• family history of obsessive-compulsive disorder, substance use or mood disorders
• head injury in some cases
• onset often in adolescence or young adulthood, sometimes much later

Conditions that often occur with it

• depression and anxiety
• bipolar disorder
• eating disorders, particularly bulimia
• substance use disorders
• other impulse control problems, such as gambling disorder

Diagnosis

A mental health professional diagnoses kleptomania through a clinical interview, asking about the pattern of urges and stealing, feelings before and after, and other symptoms. They rule out other explanations such as mania, psychosis, dementia, conduct disorder or antisocial personality disorder. Shame often prevents people from seeking help, so a non-judgmental approach is important.

Treatment

Psychotherapy

Cognitive behavioral therapy (CBT) is the main treatment. Techniques include:

• covert sensitization: imagining stealing followed by imagining negative consequences, such as being caught
• aversion and exposure techniques
• systematic desensitization and relaxation to manage urges
• identifying triggers, such as stress or certain stores, and planning alternatives

Medicines

There is no FDA-approved medicine for kleptomania. Options studied include:

• naltrexone, an opioid antagonist used for addictions, which reduced urges in a small trial
• SSRIs, particularly when depression or anxiety coexist, with mixed results
• treatment of co-occurring conditions

Practical steps

• avoiding high-risk situations, such as shopping alone
• telling a trusted person and agreeing on a plan
• support groups for compulsive stealing or impulse control problems

Outlook

Kleptomania can be long-lasting, with periods of improvement and relapse, but many people reduce or stop stealing with treatment. Legal consequences, shame and depression are common, and thoughts of suicide are more frequent than in the general population, which makes early help important.

Frequently asked questions

What is kleptomania?

Kleptomania is an impulse control disorder in which a person repeatedly cannot resist urges to steal items they do not need. Tension builds before stealing, relief follows, and then guilt or shame. It is rare and different from ordinary shoplifting.

What causes kleptomania?

The exact cause is unknown. It may involve differences in brain chemicals such as serotonin and dopamine, and it is linked to family histories of addiction, OCD and mood disorders. It often coexists with depression, anxiety or eating disorders.

Is kleptomania treatable?

Yes. Cognitive behavioral therapy is the main treatment and helps people manage urges and triggers. Some people benefit from medicines such as naltrexone or antidepressants, especially when other conditions are present.

Is kleptomania a defense for stealing?

Kleptomania is a recognized mental health condition, but it is not generally a legal excuse for theft. Courts may consider it when deciding on treatment-focused sentencing. Legal advice is needed for specific situations.