Is Lindsay Lohan really responsible for stealing that necklace?

The 1905 silent film The Kleptomaniac is a social commentary about two women, from different social classes, who both commit shoplifting crimes and are caught, arrested and taken to court. The film highlights the different ways in which the two women, one rich and one poor, are dealt with by the criminal justice system. Social commentary aside, is there a difference between ordinary shoplifting and kleptomania as a mental illness? According to doctors, the answer is: yes.

Kleptomania is recognized by the American Psychiatric Association as an Impulse Control Disorder (others include Intermittent Explosive Disorder, Pathological Gambling, Pyromania and Trichotillomania). Kleptomania was first described in 1838 by French psychiatrist Jean-Etienne Esquirol. People with kleptomania differ from ordinary shoplifters because they do not steal for personal gain but rather to relieve psychological symptoms. (“I have kleptomania, but when it gets bad, I take something for it.”)

To be diagnosed with kleptomania, a person needs to meet the following 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 release 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 hallucination
  5. The stealing is not better explained by another mental disorder such as Conduct Disorder, a Manic Episode or Antisocial Personality Disorder

Kleptomania frequently occurs with other psychiatric illnesses, particularly affective (mood) disorders, substance abuse and anxiety disorders. What causes kleptomania is unknown but it may run in families and is more common in women. There is no drug to treat kleptomania (although Naltrexone, approved for the treatment of alcohol dependence, is being tried); cognitive behavioral therapy (CBT) is helpful.

What are the odds that someone who shoplifts is a bona fide kleptomaniac? One survey of 791 college students showed that, although nearly 29% admitted to having stolen something in his/her lifetime, less than half of 1% met the diagnostic criteria (see above) for kleptomania. Based on this data, more than 99% of shoplifters do not have kleptomania.

More information at Resounding Health

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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