Kleptomania on the impulsive–compulsive spectrum. Clinical and therapeutic considerations for women

Abstract

The current literature regarding kleptomania (KM) is scarce, especially regarding treatment approaches and outcomes. The aims of the present study involved: (1) exploring characteristics of people with KM (with and without co-occurring eating disorders (EDs)); (2) considering KM along an impulsive-compulsive spectrum; and, (3) investigating treatment outcomes in a clinical sample of female patients with KM. The study sample included 150 female participants with either a diagnosis of KM only (n = 13), co-occurring KM and EDs (n = 71), or healthy control individuals (HCs) (n = 66). The KM-only group was diagnosed using DSM-5 criteria and by a face-to-face clinical interviewed. EDs were diagnosed through a face-to-face semi-structured clinical interview based on DSM-5 criteria, and co-occurring KM was self-reported by patients. Psychopathology, impulsivity and personality features were assessed. Clinical groups received cognitive behavioral treatment. Compared to HCs, both KM groups reported more psychopathology, higher impulsivity, and more dysfunctional personality features. Relative to the clinical groups, that with KM + ED was more impulsive; in contrast, harm avoidance scores were higher in the KM-only group. Both clinical groups present poor treatment outcomes. KM can present impulsive and compulsive features, and these may impact treatment outcomes. Co-occurring KM and EDs may worsen clinical profiles and warrant specific interventions.