A diagnosis of “pyromania” applies to a person who performs deliberate and purposeful fire setting on more than one occasion. In addition, the individual:

• Experiences tension or affective arousal before the act.
• Has a fascination with, interest in, curiosity about, or attraction to fire and its situational contexts (e.g., paraphernalia, uses, consequences)
• Feels pleasure, gratification, or relief when setting fires or when witnessing or participating in their aftermath.

The fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances, in response to a delusion or hallucination, or as a result of impaired judgment (e.g., in major neurocognitive disorder, intellectual disability, substance intoxication).

What are treatments for Pyromania?

No single treatment has proven effective in treating pyromania. Because of the recurrent nature of pyromania, any treatment program should include supervision of the patient to prevent a repeated episode of fire setting. Incarceration may be the only method preventing a recurrence. Behavior therapy can then be administered in the institution.

Firesetting by children must be treated with the utmost seriousness. Intensive interventions should be undertaken when possible as therapeutic and preventive measures, not as a punishment. In the case of children and adolescents, treatment should include family therapy.

Pyromania is often associated with substance abuse disorder (especially alcoholism), depressive or bipolar disorders, other impulse-control disorders, such as kleptomania in female firesetters, and Pyromania is often associated with substance abuse disorders (especially alcoholism), depressive or bipolar disorders, other impulse-control disorders, such as kleptomania in female firesetters, and various personality disturbances, such as inadequate and borderline personality disorders. Attention-deficit/hyperactivity disorder (ADHD) and learning disabilities may be especially associated with childhood pyromania. Firesetters also tend to have a history of antisocial traits, such as truancy, running away from home, and delinquency. Co-existing conditions also need to be treated as appropriate.

What is Kleptomania?

A diagnosis of “kleptomania” is given to a person who repeatedly steals objects that are not needed for personal use or for their monetary value. The individual:

• Experiences an increasing sense of tension immediately before committing the theft.
• Feels pleasure, gratification, or relief at the time of committing the theft.
• Do not steal to express anger or vengeance, or in response to a delusion or a hallucination.

Stealing is not better explained by conduct disorder, a manic episode, or antisocial personality disorder.

What are treatments for Kleptomania?

Behavior therapy, including systematic desensitization and aversive conditioning, has proven successful in treating patients with kleptomania. Those who feel guilt and shame may be helped by insight-oriented psychotherapy. Pharmacotherapy may also be helpful. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and fluvoxamine (Luvox) appear to be effective in some patients. Case reports have also indicated successful treatment using tricyclic drugs, trazodone, lithium, valproate, and naltrexone.

What are the causes of Impulse-Control Disorders?

Psychological, social, and biological factors all play a role in impulse-control disorders, which include intermittent explosive disorder, kleptomania, and pyromania.

Psychological factors often include psychic trauma from childhood, including exposure to violence in the home, abuse, alcohol abuse, promiscuity, and antisocial behavior. Impulsive behavior may be an attempt to master anxiety, guilt, depression, or an incomplete sense of self.

Research concerning biological factors associates violent and aggressive behavior with abnormal brain chemistry and certain hormones, especially testosterone. Individuals diagnosed with childhood attention-deficit hyperactivity disorder (ADHD) may have impulse-control disorder symptoms that continue into adulthood. In addition, lifelong or acquired mental deficiency, epilepsy, and even reversible brain syndromes have long been implicated in persons with impulse control problems.

In some cases, genetic factors may also play a role. First-degree relatives of patients with the intermittent explosive disorder have higher rates of impulse-control disorders, depressive disorders, and substance use disorders.