Kleptomania is an addiction to stealing without an economic motive; therefore, an examination of effective interventions as a preventive measure is needed. The effectiveness of cognitive behavioural therapy (CBT) combined with mindfulness for the treatment of addiction has been previously indicated, and it is presumed to be effective for kleptomania; however, this relationship remains unstudied. Therefore, this study aimed to examine the effectiveness of cognitive behavioural group therapy (CBGT) combined with mindfulness for treating kleptomania. The results of a 12-session programme of CBGT combined with mindfulness for 22 patients with kleptomania showed that kleptomania symptoms and quality of life (QOL) improved. Furthermore, the recovery process revealed that the improvement of distress tolerance affected the improvement of kleptomania symptoms and that the improvement of reward perception and distress tolerance affected the improvement of stress response and QOL. These results suggest that CBGT combined with mindfulness may be effective in improving symptoms and QOL in kleptomania.

Kleptomania is an impulse control disorder characterized by the irresistible urge to steal not for monetary gain. Since its conceptualization, this categorical diagnosis has been conflated with common beliefs regarding the social class and gender such as the idea that women are intrinsically fragile and that people in the middle class were unlikely to commit theft. Also, its use has been controversial in the medical and forensic fields. This presentation will provide a historical excursus through the definitions of the syndrome and summarize the available pharmacological and psychotherapeutic options for its treatment. Currently, there is a lack of systematic studies regarding the clinical characteristics of kleptomania and its treatment options for practical standardized approaches.

The extension of the definition of dependence leads to the consideration of some impulsive disorders as a form of dependence disorder. This pathological condition is characterized by the repetitive occurrence of impulsive and uncontrolled behaviors. Other clinical characteristics are failure to resist an impulse, drive or temptation to perform some act harmful to oneself and/or others, an increasing sense of tension or excitement before acting out, and a sense of pleasure, gratification or release at the time of the behavior or shortly thereafter. Behavioral dependences most often described are pathological gambling, kleptomania, trichotillomania and compulsive buying.

Studies using a specific assessment scale, the South Oaks Gambling Screen, distinguished problem gambling from pathological gambling. Social gamblers spend 5% of their money and pathological gamblers 14 to 45%. Prevalence of ‘problem gambling’ is 4% and pathological gambling 2%. Several studies have suggested that the incidence of pathological gambling is eight to ten times greater in alcohol-dependent patients than in the general population.

No systematic study has assessed the prevalence of kleptomania. Data come from case reports. Among subjects arrested after a theft, prevalence of kleptomania varied between 0 and 24%. Trichotillomania prevalence rate is 0.6% among students. Studies using less restrictive diagnostic criteria found a prevalence rate of 3.4% in women and 1.5% in men. The disorder is often unrecognized; 40% of the cases are not diagnosed and 58% of the patients have never been treated.

Prevalence studies of compulsive buying found a rate between 1 and 6% in the general population. Compulsive buying is significantly more frequent among women (90% of the cases). Study of family history of compulsive buyers showed a high frequency of alcohol-dependence disorder (20%) and depression (18%). In all cases of behavioral dependence disorders, a high level of impulsivity and sensation-seeking could determine an increased risk.

A review of the literature showed that there is no good systematic study of a series of rigorously diagnosed “kleptomaniac” persons, other than those referred by the courts for expert opinions. This applies in particular to German-speaking and other European countries. We therefore report here on the phenomenology, demographics, psychopathology, family histories, treatment histories, behaviour therapy oriented analyses, and treatment results of 12 individuals meeting Diagnostic and Statistical Manual (DSM)-III-R criteria for kleptomania. All patients described an uncontrollable impulse to steal and a reduction in anxiety or tension during or after the act. All had at least one further psychiatric diagnosis. Although the kleptomaniac symptomatology did not seem to be part of these other disorders, the extent of stealing corresponded (positively or negatively) to other psychiatric symptoms such as depressive feelings, excessive urges to eat or migraine attacks. Microanalysis of the act of theft, as well as the preceding and following events (explored by applying behaviour therapy oriented analysis) showed intraindividually consistent, but inter-individually differing triggering factors. There was no evidence of correlation with obsessive-compulsive disorders, but some indications that kleptomania may be associated with affective disorders in terms of an “affective spectrum disorder”. According to a broader definition of “multi-impulsive-disorder” (analogous to Lacey and Evans or Fichter et al), one third of the patients might be diagnosed as “bi-impulsive disorder”. Eight of the 12 patients could be investigated at a mean follow-up time of 2 years after discharge showing favourable results. In conclusion, kleptomaniac behaviour seems to be multiconditionally caused and sustained.

Kleptomania and pathological gambling (PG) are currently classified in the DSM IV as impulse control disorders. Impulse control disorders are characterized by an overwhelming temptation to perform an act that is harmful to the person or others. The patient usually feels a sense of tension before committing the act and then experiences pleasure or relief while in the process of performing the act. Kleptomania and PG are often associated with other comorbid psychiatric diagnoses. Forty-four pathological gamblers and 19 kleptomanics were included in this study. All enrolled patients underwent a complete diagnostic psychiatric evaluation and were examined for symptoms of depression and anxiety using the Hamilton depression rating scale and the Hamilton anxiety rating scale, respectively. In addition, the patients completed self-report questionnaires about their demographic status and addictive behavior. The comorbid lifetime diagnoses found at a high prevalence among our kleptomanic patients included 47% with affective disorders (9/19) and 37% with anxiety disorders (7/19). The comorbid lifetime diagnoses found at a high prevalence in our sample of pathological gamblers included 27% with affective disorders (12/44), 21% with alcohol abuse (9/44), and 7% with a history of substance abuse (3/44). A larger study is needed to confirm these preliminary results.