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Abstract: Kleptomania, characterized by repetitive, uncontrollable stealing of items not needed for personal use, is a disabling disorder that often goes unrecognized in clinical practice. Although originally conceptualized as an obsessive compulsive spectrum disorder, emerging evidence (clinical characteristics, familial transmission, and treatment response) suggests that kleptomania may have important similarities to both addictive and mood disorders. In particular, kleptomania frequently co-occurs with substance use disorders, and it is common for individuals with kleptomania to have first-degree relatives who suffer from a substance use disorder. Additionally, there is some suggestion that selective serotonin reuptake inhibitors, the treatment of choice for obsessive compulsive disorder, may lack efficacy for kleptomania. Instead, other medications (lithium, anti-epileptics, and opioid antagonists) have shown early promise in treating kleptomania. Evidence suggests that there may be subtypes of kleptomania that are more like OCD, whereas others have more similarities to addictive and mood disorders. Subtyping of individuals with kleptomania may be a useful way to better understand this behavior and decide on effective treatment interventions.
Introduction
Although shoplifting dates back centuries, the idea that some people may not be able to control their stealing was first seriously examined in 1838 (1). At that time, two French physicians, Jean-Etienne Esquirol and C.C. Marc coined the term "kleptomanie" to describe shoplifting characterized as involuntary and irresistible (1). Since that time, only episodic mention is made of kleptomania in the scientific literature. In 1952, the first Diagnostic and Statistical Manual of Mental Disorders (DSM-I) included kleptomania as a supplementary term rather than as a distinct diagnosis, but kleptomania was then left out altogether in DSM-II (1968). Since its reappearance in DSM-III (1980), it has been categorized as an impulse-control disorder not elsewhere classified, and remains this way in the current DSMIV-TR (2000) (2).
Kleptomania is defined by the following diagnostic criteria: 1) recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value; 2) increasing sense of tension immediately before committing the theft; 3) pleasure, gratification, or relief at the time of committing the theft; 4) the stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination; and 5) the stealing is not better accounted...