Kleptomania
What is kleptomania?
Kleptomania, known as stealing disorder, is a psychological disorder. Kleptomania is an impulse control disorder characterized by the inability to resist the urge to steal objects even though it has no monetary value and is not needed for personal use. It is a disorder that usually begins in adolescence, lasts until late adulthood, and can last a lifetime in some patients. Its prevalence among the population cannot be determined precisely because it is rare and causes social stigma, and the search for treatment is limited. Studies have revealed that between 3.8% and 10% of thieves are kleptomaniacs.
Stolen items are usually kept unused, and some people may donate stolen items or gift them to family members and friends. Sometimes they can go back to where they stole and leave. The urge to steal may come and go from time to time, and it may be felt less or more intensely over time.
What are the symptoms of kleptomania?
- Strong impulsivity to steal unneeded items and an inability to control these urges
- Feeling of tension, anxiety, or arousal when impulses occur
- Feeling a sense of pleasure, relaxation, or satisfaction while playing
- Feelings of guilt, remorse, self-hatred, embarrassment, or fear of being arrested after the theft
- Return of impulses and repetition of the kleptomaniac cycle.
Why Does Kleptomania Occur?
- Serotonin-related problems: Since the happy neurotransmitter called serotonin, which is normally found in the brain, helps regulate mood and emotions, low levels of serotonin are observed in people who are prone to impulse control disorder.
- Addictive disorders: Stealing can cause the release of another neurotransmitter called dopamine. Dopamine causes feelings of reward and fulfillment, and some people want to relive that rewarding feeling over and over.
- Disorders of the brain’s opioid system: Impulses are regulated by the brain’s opioid system. An imbalance in this system can make it difficult to resist impulses.
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What are the Kleptomania Risk Factors?
Kleptomania usually begins during the teenage years or young adulthood, and can sometimes begin in adulthood or later. About two-thirds of diagnosed patients are women.
• Family History: Having a first-degree relative, such as a parent or sibling with kleptomania or obsessive-compulsive disorder, or an alcohol or other substance use disorder, may increase the risk of developing the disease.
• Presence of an additional psychological disorder: These people usually also have another psychological disorder such as bipolar disorder, anxiety disorder, eating disorder, substance use disorder or personality disorder.
Stealing Behavior in Children
It is necessary to remember that in the period of 2-8 years, children who have not yet perceived the concept of ownership are not aware of the need to take permission because they are not yet mature in sharing. The act of trespassing in this age period may not be kleptomania.
Excessive discipline of the parent, comparing their child with their peers, critical attitude, not giving positive feedback to the child may cause this behavior to occur. If there is tension and violence between parents, the child may be dragged into stealing behavior.
What is the Effect of Kleptomania on Criminal Liability?
Kleptomania (Stealing Disease) is not exactly a mental illness. The patient’s ability to direct his behavior in relation to the act he committed is reduced.
Courts may reduce the sentence to be imposed on the accused in accordance with Article 32/2 of the Turkish Penal Code, or they may apply security measures specific to the mentally ill.
Turkish Penal Code No. 5237
mental illness
Article 32-
(2) A person whose ability to direct his behavior in relation to the act he has committed, although not to the degree stated in the first paragraph, has decreased, is sentenced to twenty-five years instead of aggravated life imprisonment, and twenty years instead of life imprisonment. In other cases, the penalty to be imposed may be reduced by no more than one sixth. The sentenced sentence can also be applied partially or completely as a security measure specific to mental patients, provided that the duration is the same.
Kleptomania Treatment
There are not enough studies on the treatment of kleptomania. There is a resistance that prevents treatment in kleptomania, and among the conditions that limit treatment in these cases are the late period in which the disease can be detected, and the long time lapse makes treatment difficult. If the patients continue to hide their kleptomanic complaints while focusing on other complaints, no progress can be made in the treatment and the success of the treatment decreases.
Because kleptomania can often be accompanied by other comorbid conditions, such as mood disorders, people often want to start treatment not for kleptomania but for other comorbid conditions that bother them.
One of the problems that complicates the stealing behavior is that it also has different problems such as depression, anxiety and identity problems.
The phenomenological similarities of kleptomania and obsessive-compulsive disorder, pathological gambling, and hair-pulling show that similar drugs and approaches can be used in their treatment.
Serotonin reuptake inhibitors (SSGI), mood stabilizers and opioid (impulse) regulating drugs are used in the treatment of kleptomania, and there are studies showing that the effectiveness of cognitive-behavioral treatment approaches is more successful than psychodynamic or psychoanalytically oriented psychotherapies. In addition, when cognitive-behavioral approaches are used together with drug therapy, more success is achieved than with drug therapy alone.
- Psychodynamic Approaches
The main goal is to reach the subconscious of the person, to determine the motivation underlying the behavior, and to help the patient change his behavior during the interviews. Psychoanalysis includes a long treatment process, and treatment outcomes related to kleptomania are controversial. In addition, long-term follow-up information is not sufficient in psychodynamic therapies, and their effectiveness is not known due to the absence of any controlled studies.
- Behavioral Therapies
In addition to the effectiveness of cognitive-behavioral therapy in disorders such as depression, anxiety problems, and pathological gambling, studies on the effectiveness of kleptomania are not included in the literature, but they are successful in the treatment of impulse control disorders, especially when used with drug support. The aim is to cognitively construct inaccurate and dysfunctional thoughts, to create alternative responses to stress with problem-solving approaches, to identify high-risk situations and to prevent repetitions by creating avoidance behavior.
With the Latent Sensitization Technique, the desire to steal is applied by associating it with the consequences of imagined stealing behaviors, and it can be used successfully by creating situations such as the person being caught or imprisoned.
- Pharmacological Treatment:
Treatment of kleptomania typically includes one or both of psychotherapy and medication. There is no standard treatment for kleptomania and research is still ongoing. It may take several different trials to find out which type of treatment works best for a person with kleptomania.
Although there is no FDA (American Food and Drug Administration, Food and Drug Administration) approved drug for kleptomania, some drug groups can be prescribed for the treatment of kleptomania:
• Naltrexone: An opioid antagonist that can reduce the urges and pleasures associated with stealing, and is essentially an addiction drug.
• Antidepressants: Especially those with selective serotonin reuptake inhibitors (SSRIs) are preferred.
