A 28-year-old man presents to the emergency department after being arrested for shoplifting. He reports uncontrollable urges to steal objects he neither needs nor intends to use, followed by a sense of release and subsequent guilt. He has been arrested 4 times. He has no financial need. There is no evidence of a manic episode, antisocial personality disorder, or delusional disorder. The diagnosis is:

• A Kleptomania ✓
• B Antisocial personality disorder
• C Conduct disorder
• D Manic episode with disinhibition

Explanation

Kleptomania is an impulse-control disorder characterised by recurrent failure to resist impulses to steal objects that are NOT needed for personal use or monetary value. The classic triad: rising tension before the act, gratification/release during the act, and guilt/remorse after. It is differentiated from ordinary theft or conduct disorder (where stealing is deliberate and driven by gain or social context), and from bipolar disorder (where it occurs only during mood episodes). There is no financial motivation. SSRIs, lithium, and naltrexone have shown benefit. It is uncommon and frequently comorbid with depression, anxiety, and eating disorders.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.