Psychiatry · Impulse Control, Gender and Paraphilic Disorders

A 40-year-old man is referred for recurrent stealing of objects he does not need for personal use or monetary value. He feels tension before stealing and relief/pleasure during the act, with subsequent guilt. Which is the CORRECT diagnosis and its DSM-5 category?

  • A Antisocial personality disorder with stealing behaviour
  • B Obsessive-compulsive disorder (compulsive stealing subtype)
  • C Kleptomania — classified under Disruptive, Impulse-Control, and Conduct Disorders
  • D Conduct disorder in adults
Correct answer: C. Kleptomania — classified under Disruptive, Impulse-Control, and Conduct Disorders

Explanation

Kleptomania is characterised by recurrent failure to resist impulses to steal objects not needed for personal use or their monetary value; a rising tension before the act; pleasure/relief/gratification during the theft; and guilt/remorse after. It is classified under Disruptive, Impulse-Control, and Conduct Disorders in DSM-5, not OCD (although ego-dystonic similarity exists). Unlike conduct disorder or antisocial personality, kleptomania stealing is impulsive, not planned for personal gain. It is associated with serotonergic dysfunction and responds to SSRIs and naltrexone.

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

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