Age at onset of kleptomania is variable, but the disorder often begins in adolescence. How- ever, the disorder may begin in childhood, adolescence, or adulthood, and in rare cases in late adulthood. There is little systematic information on the course of kleptomania, but three typical courses have been described: sporadic with brief episodes and long periods of remission; episodic with protracted periods of stealing and periods of remission; and chronic with some degree of ﬂuctuation. The disorder may continue for years, despite multiple convictions for shoplifting.
Other Specified Disruptive, Impulse-Control, and Conduct Disorder 479
Genetic and physiological. There are no controlled family history studies of kleptoma- nia. However, first-degree relatives of individuals with kleptomania may have higher rates of obsessive-compulsive disorder than the general population. There also appears to be a higher rate of substance use disorders, including alcohol use disorder, in relatives of individuals with kleptomania than in the general population.
Functionai Consequences of Kleptomania
The disorder may cause legal, family, career, and personal difficulties.
Ordinary theft. Kleptomania should be distinguished from ordinary acts of theft or shoplifting. Ordinary theft (whether planned or impulsive) is deliberate and is motivated by the usefulness of the object or its monetary worth. Some individuals, especially adoles- cents, may also steal on a dare, as an act of rebellion, or as a rite of passage. The diagnosis is not made unless other characteristic features of kleptomania are also present. Klepto- mania is exceedingly rare, whereas shoplifting is relatively common.
Malingering. In malingering, individuals may simulate the symptoms of kleptomania to avoid criminal prosecution.
Antisocial personality disorder and conduct disorder. Antisocial personality disorder and conduct disorder are distinguished from kleptomania by a general pattern of antiso— cial behavior.
Manic episodes, psychotic episodes, and major neurocognitive disorder. Kleptomania manic episode, in response to delusions or hallucinations (as in, e.g., schizophrenia), or as a result of a major neurocognitive disorder.
Kleptomania may be associated with compulsive buying as well as with depressive and bipolar disorders (especially major depressive disorder), anxiety disorders, eating disor- ders (particularly bulimia nervosa), personality disorders, substance use disorders (espe- cially alcohol use disorder), and other disruptive, impulse-control, and conduct disorders.
Other Specified Disruptive, Impulse-Control, 312.89 (F91.8)
This category applies to presentations in which symptoms characteristic of a disruptive, impulse-control, and conduct disorder that cause clinically significant distress or impair- ment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the disruptive, impulse-control, and con- duct disorders diagnostic class. The other specified disruptive. impulse-control, and con- duct disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific disrup- tive, impulse-control, and conduct disorder. This is done by recording “other specified dis- ruptive, impulse-control, and conduct disorder" followed by the specific reason (e.g., “recurrent behavioral outbursts of insufficient frequency").
480 Disruptive, Impulse-Control, and Conduct Disorders
Unspecified Disruptive, Impulse-Control, 312.9 (F91.9)