Description
Kleptomania is a complex disorder characterized by repeated, failed attempts to stop stealing. It is often seen in patients who are chemically dependent or who have a coexisting mood, anxiety, or eating disorder. Other coexisting mental disorders may include major depression, panic attacks, social phobia , anorexia nervosa , bulimia nervosa , substance abuse, and obsessive-compulsive disorder . People with this disorder have an overwhelming urge to steal and get a thrill from doing so. The recurrent act of stealing may be restricted to specific objects and settings, but the affected person may or may not describe these special preferences. People with this disorder usually exhibit guilt after the theft.

Detection of kleptomania, even by significant others, is difficult and the disorder often proceeds undetected. There may be preferred objects and environments where theft occurs. One theory proposes that the thrill of stealing helps to alleviate symptoms in persons who are clinically depressed.

Demographics
Studies suggest that 0.6% of the general population may have this disorder and that it is more common in females. In patients who have histories of obsessive-compulsive disorder, some studies suggest a 7% correlation with kleptomania. Other studies have reported a particularly high (65%) correlation of kleptomania in patients with bulimia.

Diagnosis
Diagnosing kleptomania is usually difficult since patients do not seek medical help for this complaint, and initial psychological assessments may not detect it. The disorder is often diagnosed when patients seek help for another reason, such as depression, bulimia, or for feeling emotionally unstable (labile) or unhappy in general (dysphoric). Initial psychological evaluations may detect a history of poor parenting, relationship conflicts, or acute stressors—abrupt occurrences that cause stress, such as moving from one home to another. The recurrent act of stealing may be restricted to specific objects and settings, but the patient may or may not describe these special preferences.

Treatments
Once the disorder is suspected and verified by an extensive psychological interview, therapy is normally directed towards impulse control, as well as any accompanying mental disorder(s). Relapse prevention strategies, with a clear understanding of specific triggers, should be stressed. Treatment may include psychotherapies such as cognitive-behavioral therapy and rational emotive therapy . Recent studies have indicated that fluoxetine (Prozac) and naltrexone (Revia) may also be helpful.