Grant Jon E, Chamberlain Samuel R
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine. Chicago, IL 60637 USA. E-MAIL:
Ann Clin Psychiatry. 2018 May;30(2):97-101.
Kleptomania (compulsive stealing) remains poorly understood, with limited data regarding its underlying pathophysiology and appropriate treatment choices.
Participants (N = 112) age 18 to 65 with a primary, current diagnosis of kleptomania were assessed for the severity of their stealing behavior and urges to steal, as well as related mental health symptoms. To identify clinical and demographic measures associated with variation in disease severity, we utilized the statistical technique of partial least squares.
Greater kleptomania symptom severity was associated with having more frequent urges to steal, feeling excited by stealing, having a current eating disorder, and having a current diagnosis of obsessivecompulsive disorder (OCD). Worse symptom severity was associated with a shorter transition time (between first stealing and diagnosis of kleptomania), as well as with a higher chance of stealing from relatives and seeking treatment at some point.
Feeling a sense of reward from stealing and co-occurrence of certain disorders associated with compulsivity (eg, OCD, anorexia nervosa) were strongly associated with worse illness severity in kleptomania. Treatment approaches should incorporate these disorders as possible treatment targets. These data also may support conceptualizing kleptomania as an obsessive-compulsive-related disorder rather than being allied to substance use or impulsive disorders.
偷窃癖（强迫性偷窃）仍未得到充分理解，关于其潜在病理生理学和适当治疗选择的数据有限。
对112名年龄在18至65岁之间、目前初步诊断为偷窃癖的参与者的偷窃行为严重程度、偷窃冲动以及相关心理健康症状进行评估。为了确定与疾病严重程度变化相关的临床和人口统计学指标，我们采用了偏最小二乘法统计技术。
偷窃癖症状严重程度越高，与越频繁的偷窃冲动、因偷窃而感到兴奋、目前患有饮食失调症以及目前被诊断为强迫症（OCD）相关。症状严重程度越差，与较短的过渡时间（从首次偷窃到诊断为偷窃癖之间）以及在某个时候从亲属处偷窃和寻求治疗的可能性越高相关。
从偷窃中获得奖励感以及与强迫性相关的某些疾病（如强迫症、神经性厌食症）的共病与偷窃癖中更严重的疾病严重程度密切相关。治疗方法应将这些疾病作为可能的治疗目标。这些数据也可能支持将偷窃癖概念化为一种与强迫症相关的疾病，而不是与物质使用或冲动性疾病相关。
