Kleptomania and shoplifting : a psychosocial study

Sammanfattning: Although kleptomania has been recognised since the 19th century very little is known about it. One often reads assumptions that the kleptomaniac is a middle-aged female with good social status and that the condition is often seen during the menopause, pregnancy or depression. However, there has been very little research in this area and there are extremely few studies based on well diagnosed kleptomaniacs. Earlier studies have collected their data from certain case reports or small series of cases from amongst psychiatric patients, eating disorder groups or from patients referred by the courts psychiatric examination. This involves bias. The aim of our study has been to obtain more information about well diagnosed kleptomaniacs which will then hopefully also contribute to the development of treatment methods. There are currently no accepted treatment methods. Our hypothesis has also been that there exists an intermediate zone between "pure" kleptomaniacs and those who steal for personal profit. These individuals also suffer from their behaviour and need help to be able to abstain from stealing although they do not fulfil all the diagnostic criteria required to be classified as kleptomaniacs according to the DSM system. We have therefore taken a look at shoplifters. Many of the kleptomaniacs and these intermediate shoplifters are very distressed by their behaviour which often has serious social and also mental health consequences. It is ethically important to be able to offer these individuals help in getting rid of their destructive behaviour. Clinical encounters with these kleptomaniac patients have evoked the feeling that they constitute a heterogeneous group with certain subgroups which we have wanted to examine more closely, also via earlier literature. We have also wanted to take a closer look at whether a typical kleptomaniac resembles the description given above. In order to avoid the type of bias mentioned above we have collected our data in three different ways: 1) We advertised in daily newspapers for people who "steal without actually wanting to". This resulted in contact with 37 DSM-III-R diagnosed kleptomaniacs; 2) We interviewed 50 shoplifters directly after they had been apprehended in central Stockholm; 3) We had access to the police register over all those caught shopliftling in the Greater Stockholm area during 1993. This study supported the view that the typical kleptomaniac is a middle-aged female with a traumatic childhood but of varying financial status. Depressions were common according the patients' own descriptions. Earlier literature as well as our study seemed to give support to the view that kleptomaniacs are a heterogeneous group and that there exists a clinically important intermediate zone which must be considered. We must remember, however, that despite this study being, as far as we know, the largest one conducted on well diagnosed kleptomaniacs the group is still relatively small and also certainly suffers from selection bias. Any conclusions must therefore be drawn with great caution.