Kleptomania: Symptoms, Types, Causes and Treatment

Kleptomania is a complex and often misunderstood condition that reaches far beyond simple acts of theft. While it is commonly mistaken for criminal behavior, kleptomania is recognized as a psychiatric disorder with unique symptoms, diverse types, and intricate causes. This article provides a comprehensive overview of kleptomania, highlighting its symptoms, various types, underlying causes, and the latest evidence-based treatment options.

Symptoms of Kleptomania

Kleptomania is defined by more than just stealing; it involves a distinctive pattern of emotions, thoughts, and behaviors. Understanding these symptoms is crucial for early identification and intervention.

Symptom	Description	Emotional Experience	Reference
Recurrent Theft	Repeated stealing of items not needed	Relief, tension reduction	2 3 5
Urges/Impulse	Inability to resist stealing urges	Increasing tension before theft	2 5
Guilt/Remorse	Feelings of guilt or shame after theft	Self-reproach	3 8
Dissociation	Altered state during theft	Detachment, unreality	1 8

Table 1: Key Symptoms

Emotional and Behavioral Cycle

At the core of kleptomania is a distinct emotional cycle:

• Growing Tension: Individuals feel mounting anxiety or emotional pressure before stealing.
• Act of Theft: The act is usually unplanned and performed to relieve tension, not for monetary gain or personal use.
• Relief and Guilt: After stealing, there is a sense of release or gratification, quickly followed by feelings of guilt, remorse, or shame 2 3 5.

Dissociative Experiences

Many people with kleptomania describe a sense of unreality or detachment during theft episodes—these are called dissociative symptoms. This altered state can make it difficult to recall details of the theft and intensifies the feeling of lack of control 1 8.

Co-Occurring Symptoms

Kleptomania rarely exists in isolation. It is frequently accompanied by symptoms of mood disorders (such as depression), anxiety, or eating disorders. Individuals may also display compulsive behaviors similar to those seen in obsessive-compulsive disorder (OCD) 2 3 7.

Types of Kleptomania

Not all cases of kleptomania are alike. Researchers have begun to identify subtypes based on underlying psychological and neurobiological factors.

Type	Core Features	Associated Disorders	Reference
OCD-like	Intrusive thoughts, ritualistic stealing	Obsessive-compulsive	2 3 6
Addictive	Pleasure/reward from theft, craving	Substance use disorders	6 7
Mood-related	Stealing linked to mood fluctuations	Major depression, bipolar	7 8 9

Table 2: Subtypes of Kleptomania

OCD-like Subtype

Some individuals experience kleptomania in a way that closely resembles OCD. They may have persistent, intrusive thoughts about stealing and follow specific rituals before or after theft. This group often benefits from treatments typically used for obsessive-compulsive spectrum disorders 2 3 6.

Addictive/Reward-Seeking Subtype

Other individuals report that stealing is exciting or rewarding, similar to the rush experienced in substance use or gambling. This type may run in families with histories of addiction and often overlaps with other impulse control issues 6 7.

Mood-Related Subtype

For some, kleptomania is closely tied to mood states, particularly depression. Theft may serve as a form of risky behavior in response to emotional lows, and these individuals often have a family history of mood disorders 7 8 9.

Dissociative and Personality Factors

A subset of people with kleptomania experience dissociative symptoms or have underlying personality disorders. These cases may be associated with traumatic or stressful childhoods, further complicating the clinical picture 1 8.

Causes of Kleptomania

The root causes of kleptomania are multifaceted and not yet fully understood. They likely involve an interplay of biological, psychological, and social factors.

Factor	Details	Evidence/Notes	Reference
Neurobiology	Serotonin, dopamine, and opioid system involvement	Neurotransmitter imbalance	4 6 12
Genetics	Family history of mood/addictive disorders	Increased risk	6 7 8
Psychological	Childhood trauma, personality traits	Biopsychosocial model	8 9
Brain Injury	Structural/functional brain changes	Head trauma, frontal lobe issues	4 10

Table 3: Causes of Kleptomania

Neurobiological Factors

Research points to disruptions in neurotransmitters—particularly serotonin, dopamine, and the opioid system—as contributing factors. Imbalances in these systems can affect impulse control, reward processing, and mood regulation 4 6 12.

• Serotonin: SSRIs (selective serotonin reuptake inhibitors) sometimes reduce symptoms, though paradoxical effects (worsening or inducing kleptomania) have been observed in rare cases 4 11.
• Dopamine: Dopaminergic drugs (especially in Parkinson's disease) can trigger kleptomania, supporting dopamine’s role in reward and impulse control 4 11.
• Opioid System: The success of opioid antagonists in some cases points to involvement of the brain’s natural reward circuitry 12 13.

Genetics and Family History

Kleptomania often co-occurs in families with histories of mood or substance use disorders, suggesting a genetic predisposition or shared vulnerability factors 6 7 8.

Psychological and Social Factors

Experiences such as childhood trauma, emotional neglect, or chronic stress may increase susceptibility to kleptomania. Personality traits—impulsivity, emotional instability, and dissociation—are also common among those affected 8 9.

Brain Injury and Structural Changes

In rare cases, kleptomania has been linked to brain injuries, especially those affecting the frontal lobes, which are responsible for impulse control and decision-making. Neuroimaging studies have shown decreased white matter integrity in these brain regions among people with kleptomania 4 10.

Treatment of Kleptomania

Despite its complexity, kleptomania can be managed with a combination of therapies tailored to the individual’s symptoms and comorbidities.

Treatment	Approach/Medication	Effectiveness/Notes	Reference
Cognitive-Behavioral	Structured psychotherapy	Reduces symptoms, relapse prevention	2 6 15
SSRIs	Selective serotonin reuptake inhibitors	Mixed results, sometimes paradoxical	2 4 14
Mood Stabilizers	Lithium, anti-epileptics	Promising for mood-related cases	6 7
Opioid Antagonists	Naltrexone	Reduces urges and stealing behavior	12 13

Table 4: Main Treatment Options

Cognitive-Behavioral Therapy (CBT)

CBT is often considered the first-line psychological intervention. It helps individuals recognize and manage the thoughts, emotions, and behaviors associated with the urge to steal. Regular follow-up and maintenance sessions are crucial, as relapse rates can be high if treatment is discontinued too soon 2 6 15.

Pharmacological Treatments

SSRIs

Medications like fluvoxamine and other SSRIs have been used, particularly in patients with prominent obsessive-compulsive features. However, their efficacy is inconsistent, and in rare cases, SSRIs may even trigger kleptomania-like symptoms 2 4 11 14.

Mood Stabilizers

Lithium and certain anti-epileptics have shown promise, especially in cases where kleptomania is linked to mood instability or bipolar disorder 6 7.

Opioid Antagonists

Naltrexone, an opioid receptor antagonist, has demonstrated significant efficacy in reducing both the urge to steal and actual stealing behavior, with good tolerability. It may be especially effective in individuals whose kleptomania resembles addictive disorders 12 13.

Personalized and Integrated Approaches

• Targeting Comorbidities: Because kleptomania often co-occurs with mood, anxiety, and eating disorders, effective management often includes addressing these conditions alongside the core symptoms of kleptomania 2 3 7.
• Neurobiological Considerations: Treatments that modulate neurotransmitter systems beyond serotonin—such as dopamine and glutamate—are being explored, though more research is needed 4 6.
• Long-Term Follow-Up: Patients benefit from ongoing support and monitoring, as kleptomania is prone to relapse and requires more than short-term interventions 15.

Conclusion

Kleptomania is a multifaceted disorder that challenges simple explanations and one-size-fits-all treatments. By recognizing its diverse symptoms, subtypes, underlying causes, and evolving therapy options, clinicians and patients can better navigate the path to recovery.

Key Takeaways:

• Kleptomania is defined by recurrent, uncontrollable stealing, accompanied by emotional cycles of tension, relief, and guilt 2 3 5.
• Subtypes include OCD-like, addictive/reward-seeking, and mood-related forms, each with unique features and comorbidities 2 3 6 7 8 9.
• Causes involve a combination of neurobiological (serotonin, dopamine, opioid system), genetic, psychological, and environmental factors 4 6 7 8 9 10 11 12.
• Treatment requires a personalized approach, combining cognitive-behavioral therapy, targeted medications (SSRIs, mood stabilizers, naltrexone), and management of comorbid psychiatric conditions 2 4 6 7 12 13 14 15.
• Ongoing research and nuanced understanding promise better outcomes for those living with this challenging disorder.

Understanding and addressing kleptomania requires compassion, rigor, and a commitment to individualized, evidence-based care.